Selection of P2Y12 antagonist, treatment initiation, and predictors of high on-treatment platelet reactivity in a “Real World” registry

Motovska, Zuzana; Ondrakova, Martina; Bednář, František; Knot, Jiří; Ulman, Jaroslav; Malý, Marek

doi:10.1016/j.thromres.2015.04.014

Cited by 13 publications

(8 citation statements)

References 35 publications

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“…Among included studies, 11 (25, 26, 29, 30, 33-37, 39, 47) studies were RCTs, 13 (23,24,27,31,32,38,(40)(41)(42)(43)(44)(45)(46) studies were prospective cohort studies, and one ( 28) study was retrospective cohort study. The publication dates of 25 studies ranged from 2012 to 2022.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The patients were all middle-aged and elderly. In terms of Platelet function test method, ten (23, 25, 26, 28-30, 32, 37-39) studies only used VN, six (24,27,(34)(35)(36)40) studies only used VASP, five studies only used MEA, two (33,47) studies used VN and VASP, and two (31,46) studies used VN and MEA. Seven (24,25,27,30,34,35,47) studies only tested platelet function after the treatment of LD.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In terms of Platelet function test method, ten (23, 25, 26, 28-30, 32, 37-39) studies only used VN, six (24,27,(34)(35)(36)40) studies only used VASP, five studies only used MEA, two (33,47) studies used VN and VASP, and two (31,46) studies used VN and MEA. Seven (24,25,27,30,34,35,47) studies only tested platelet function after the treatment of LD. Seventeen (23,28,29,(31)(32)(33)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46) studies only tested platelet function after the treatment of MTD.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Impact of Prasugrel and Ticagrelor on Platelet Reactivity in Patients With Acute Coronary Syndrome: A Meta-Analysis

Dai

Jiang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThis meta-analysis mainly aimed to compare the impact of prasugrel and ticagrelor on platelet reactivity (PR) in patients with acute coronary syndrome (ACS).MethodsWe searched four electronic databases to identify randomized controlled trials and cohort studies comparing the impact of prasugrel and ticagrelor on PR in patients with ACS. We performed group analyses according to three detection methods, drug dose [loading dose (LD) and maintenance dose (MTD)] and LD effect time, and assessed the robustness of the results through sensitivity analysis.ResultsTwenty-five studies with 5,098 patients were eligible. After LD, the incidence of high on-treatment platelet reactivity (HTPR) of ticagrelor was significantly lower than that of prasugrel within 6–18 h based on vasodilator-stimulated phosphoprotein (VASP) test [RR = 0.25 (0.07, 0.85), P = 0.03], there was no significant difference between ticagrelor and prasugrel in the following results: platelets inhibitory effect within 24–48 h based on VerifyNow P2Y12 (VN) assay (P = 0.11) and VASP test (P = 0.20), and the incidence of HTPR within 2–6 h based on VN assay (P = 0.57) and within 24–48 h based on VN assay (P = 0.46) and VASP test (P = 0.72), the incidence of low on-treatment platelet reactivity (LTPR) within 6–18 h based on VASP test (P = 0.46) and 48 h based on VN assay (P = 0.97) and VASP test (P = 0.73). After MTD, the platelet inhibitory effect of ticagrelor was stronger than that of prasugrel based on VN assay [WMD = −41.64 (−47.16, −36.11), P < 0.00001]and VASP test [WMD = −9.10 (−13.88, −4.32), P = 0.0002], the incidence of HTPR of ticagrelor was significantly lower than that of prasugrel based on VN assay [RR = 0.05 (0.02, 0.16), P < 0.00001], the incidence of LTPR of ticagrelor was significantly higher than prasugrel based on VN assay [RR = 6.54 (4.21, 10.14), P < 0.00001] and VASP test [RR = 2.65 (1.78, 3.96), P < 0.00001], the results of Multiple Electrode Aggregometry (MEA) test was inconsistent with the other two detection methods in platelet inhibitory effect and the incidence of HTPR and LTPR. There was no significant difference between ticagrelor and prasugrel in the following clinical outcomes: all-cause death (P = 0.86), cardiovascular death (P = 0.49), myocardial infarction (P = 0.67), stroke (P = 0.51), target vessel revascularization (P = 0.51), stent thrombosis (P = 0.90), TIMI major bleeding (P = 0.86) and bleeding BARC type ≥ 2 (P = 0.77). The risk of bleeding BARC type 1 of ticagrelor was significantly higher than prasugrel [RR = 1.44 (1.03, 2.02), P = 0.03].ConclusionsCompared with prasugrel, ticagrelor might have a stronger platelet inhibition effect, with a lower incidence of HTPR and a higher incidence of LTPR and bleeding BARC type 1, while there might be no significant difference in the risk of thrombosis/ischemic, bleeding BARC Type ≥ 2 and TIMI major bleeding. A higher incidence of LTPR might indicate a higher risk of bleeding BARC type 1. The results of VN assay were consistent with that of VASP test, and not with the MEA test.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022304205, identifier: CRD42022304205.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Impact of Prasugrel and Ticagrelor on Platelet Reactivity in Patients With Acute Coronary Syndrome: A Meta-Analysis

Dai

Jiang

et al. 2022

Front. Cardiovasc. Med.

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“…В работе Мотовски (Motovska) и соавт. [35] при анализе фосфорилирования тромбоцитарного белка VASP (которое снижается при активации тром-боцитов АДФ) было показано негативное вли-яние высокого СОТ на эффективность дейст-вия новых, более сильных (по сравнению с клопидогрелом) антагонистов P2Y12 рецепто-ров АДФ -прасугрела и тикагрелора. Однако данные по тикагрелору не получили подтвер-ждения в работе Вердойя (Verdoia) [36] и соавт.…”

Section: средний объем тромбоцитов у больных с сердечно-сосудистыми пunclassified

Platelet Turnover and Atherothrombosis

Мазуров¹

2017

Aterotromboz

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ОБОРОТ ТРОМБОЦИТОВ И АТЕРОТРОМБОЗА.В. МАЗУРОВ, д.м.н., профессор, Научный медицинский исследовательский центр кардиологии Минздрава России, Москва КЛЮЧЕВЫЕ СЛОВА: тромбоциты, атеротромбоз, ретикулярные тромбоциты, средний объем тромбоцитов, агрегация тромбоцитов, мегакариоциты, тромбоцитопоэз Тромбоциты играют ведущую роль в инициации атеротромбоза -образования внутрисо-судистых тромбов в участках атеросклеротическом повреждении сосудов. Функциональ-ная (протромботическая) активность тромбоцитов существенным образом варьирует как у здоровых лиц, так и у пациентов с сердечно-сосудистыми заболеваниями. Одной из причин повышения активности тромбоцитов может быть ускорение их продукции и оборота. При стимуляции тромбоцитопоэза в кровотоке появляются крупные и ретику-лярные (с повышенным количеством РНК) «молодые» тромбоциты. Эти тромбоциты со-держат больше адгезивных рецепторов, больше секреторных гранул и обладают повы-шенной способностью к агрегации. В обзоре приводятся данные, указывающие на то, что крупные и ретикулярные тромбоциты являются не только маркерами, но и предик-торами атеротромботических событий, и в первую очередь острого коронарного синдро-ма. Увеличение количества таких тромбоцитов у больных, получающих антитромбоци-тарные препараты, ассоциировано со снижением эффективности их антиагрегантного действия. Предполагается, что появление крупных и ретикулярных тромбоцитов в кро-ви больных с атеросклерозом и атеротромбозом может быть следствием повышения тромбопоэтической активности мегакариоцитов при этих патологических состояниях.KEYWORDS: thrombocytes, atherothrombosis, reticular platelets, average platelet count, platelet aggregation, megakaryocytes, thrombocytopoiesis PLATELET TURNOVER AND ATHEROTHROMBOSIS A.V. MAZUROV, MD, Prof. National Medical Research Cardiology Center, Russian Ministry of Health, MoscowPlatelets play an important role in initiating atherothrombosis, i.e. the formation of blood clots inside a blood vessel at areas of atherosclerotic vascular injury. The functional (prothrombotic) activity of platelets significantly varies both in healthy individuals and in patients with cardiovascular diseases. The increased platelet production and turnover may be one of the reasons for promoting platelet activity. Stimulating thrombocytopoiesis results in large and reticular (with an increased amount of RNA) "young" platelets in the bloodstream. These platelets contain more adhesive receptors, more secretory granules and have an increased aggregation capacity. The review provides data indicating that large and reticular platelets are not only markers, but also predictors of atherothrombotic events, and primarily of acute coronary syndrome. An increase in such platelet count in patients receiving antiplatelet drugs is associated with a decrease in effectiveness of their antiplatelet action. It is assumed that the appearance of large and reticular platelets in the blood of patients with atherosclerosis and atherothrombosis may be a consequence of an increase in the thrombopoietic activity of meg...

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“…The mean platelet volume (MPV) was indeed proposed as a marker of platelet activity, since larger platelets are haemostatically more active and thought to display a greater prothrombotic potential than smaller platelets [4]. Scarce studies investigating whether MPV might increase ontreatment PR found conflicting results [5,6,7,8], but meanwhile MPV was shown to predict outcomes in ACS patients in several studies [9].Otherwise, inflammation has been demonstrated to be significantly associated with high PR [10].New inflammatory markers derived from CBC as the plateletlymphocyte ratio (PLR) and the neutrophil-lymphocyte ratio (NLR) could also potently be associated with PR since they were recently demonstrated to correlate with adverse cardiovascular outcomes in myocardial infarction patients [11], and unstable angina patients [12].…”

mentioning

confidence: 99%

Parameters of complete blood count do not predict on-treatment platelet reactivity in acute coronary syndrome patients

Bonello

Laine

Baccini

et al. 2017

Thrombosis Research

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Selection of P2Y12 antagonist, treatment initiation, and predictors of high on-treatment platelet reactivity in a “Real World” registry

Cited by 13 publications

References 35 publications

Impact of Prasugrel and Ticagrelor on Platelet Reactivity in Patients With Acute Coronary Syndrome: A Meta-Analysis

Impact of Prasugrel and Ticagrelor on Platelet Reactivity in Patients With Acute Coronary Syndrome: A Meta-Analysis

Platelet Turnover and Atherothrombosis

Parameters of complete blood count do not predict on-treatment platelet reactivity in acute coronary syndrome patients

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