Journal
EUROPEAN HEART JOURNAL
Volume 36, Issue 45, Pages 3202-3210Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehv326
Keywords
Reticulated platelets; Platelet aggregation; Ticagrelor; Prasugrel; Acute coronary syndrome
Categories
Funding
- Deutsches Zentrum fur Herzkreislauf-forschung (DZHK) [81X1600501]
- MSD SHARP AND DOHME GMBH
Ask authors/readers for more resources
Aims The influence of reticulated platelets (RPs) on platelet inhibition by ticagrelor when compared with prasugrel is unknown. We aimed to determine the influence of RPs on adenosine diphosphate-(ADP-) induced platelet aggregation in patients with acute coronary syndrome who were randomly assigned to receive either ticagrelor or prasugrel for P2Y(12) receptor inhibition. Methods and results One hundred and twenty-four patients were prospectively enrolled. The immature platelet fraction (IPF) was measured by an automated haematoanalyzer and platelet aggregation was assessed by multiple electrode aggregometry. In a subgroup of patients (n = 28) ADP-induced P-selectin expression was measured in dependence of the time point of study drug intake in RPs that were discriminated from mature platelets by thiazole-orange (TO) staining. The primary endpoint was the correlation of platelet aggregation and IPF in ticagrelor-vs. prasugrel-treated patients. Platelet aggregation significantly correlated with IPF in patients who received prasugrel (r = 0.41, P < 0.001). In contrast, no correlation between IPF and platelet aggregation was observed in ticagrelor-treated patients (r = 0.08, P = 0.51, P for difference of correlation coefficients P = 0.05). Within the TO-positive RP fraction, P-selectin expression was significantly higher in prasugrel when compared with ticagrelor-treated individuals (prasugrel 18.6 +/- 16.0% vs. ticagrelor 11.5 +/- 6.0%, P = 0.047). A time-dependent P-selectin expression was observed in prasugrel but not in ticagrelor-treated patients (prasugrel early 11.9 +/- 9.4% vs. late 26.3 +/- 19.0%, P = 0.031, ticagrelor early 9.6 +/- 4.9% vs. late 13.5 +/- 6.6%, P = 0.127). Conclusion Reticulated platelets show a greater impact on platelet reactivity in response to prasugrel when compared with ticagrelor.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available