Prasugrel Versus High Dose Clopidogrel in Clopidogrel Resistant Patients Post Percutaneous Coronary Intervention (PCI).
Status:
Completed
Trial end date:
2010-07-01
Target enrollment:
Participant gender:
Summary
The use of dual antiplatelet therapy is considered standard of care in patients post
percutaneous coronary intervention (PCI) with stenting. However, a significant proportion of
patients is considered clopidogrel resistant and this resistance is shown to be accompanied
by future adverse events. Additionally, clopidogrel resistance has been linked with the
CYP2C19 polymorphism. The hypothesis of the study is to define in consecutive patients
undergoing PCI those that are clopidogrel resistant PCI following routinely used loading as
estimated predischarge with the VerifyNow point of care system of platelet reactivity.
Clopidogrel resistant patients will be randomized in 1:1 fashion to prasugrel 10 mg or
clopidogrel 150mg daily. Platelet reactivity will be assessed at day 30, when treatment
crossover will be performed. At day 60 platelet reactivity will be determined as well. In
addition, in all patients genetic determination of CYP polymorphisms (including the
CYP2C19)known to affect clopidogrel metabolism will be performed.