Adequate platelet inhibition early in the course of ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention is essential to reduce stent thrombosis and recurrent myocardial infarction. Pharmacodynamic data now suggest that additional platelet inhibition beyond that provided by either prasugrel or ticagrelor might be necessary.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Yousuf, O. & Bhatt, D. L. The evolution of antiplatelet therapy in cardiovascular disease. Nat. Rev. Cardiol. 8, 547–559 (2011).
Wiviott, S. D. et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N. Engl. J. Med. 357, 2001–2015 (2007).
Wallentin, L. et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N. Engl. J. Med. 361, 1045–1057 (2009).
Montalescot, G. et al. Prasugrel compared with clopidogrel in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (TRITON-TIMI 38): double-blind, randomised controlled trial. Lancet 373, 723–731 (2009).
Steg, P. G. et al. Ticagrelor versus clopidogrel in patients with ST-elevation acute coronary syndromes intended for reperfusion with primary percutaneous coronary intervention: a Platelet Inhibition and Patient Outcomes (PLATO) trial subgroup analysis. Circulation 122, 2131–2141 (2010).
Alexopoulos, D. et al. Randomized assessment of ticagrelor versus prasugrel antiplatelet effects in patients with ST-segment-elevation myocardial infarction. Circ. Cardiovasc. Interv. 5, 797–804 (2012).
Bhatt, D. L. Intensifying platelet inhibition—navigating between Scylla and Charybdis. N. Engl. J. Med. 357, 2078–2081 (2007).
Heestermans, A. A. et al. Impaired bio-availability of clopidogrel in patients with a ST-segment elevation myocardial infarction. Thromb. Res. 122, 776–781 (2008).
Bhatt, D. L. Intravenous platelet blockade with cangrelor during PCI. N. Engl. J. Med. 361, 2330–2341 (2009).
Leonardi, S. et al. Rationale and design of the Cangrelor versus standard therapy to acHieve optimal Management of Platelet InhibitiON PHOENIX trial. Am. Heart J. 5, 768–776e2 (2012).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
D. L. Bhatt has received research grants from the following companies: Amarin, AstraZeneca, Bristol–Myers Squibb, Eisai, Ethicon, The Medicines Company, Medtronic, and Sanofi Aventis; and has performed unfunded research for FlowCo, PLx Pharma, and Takeda. D. L. Bhatt has received honoraria from the American College of Cardiology (as an editor of Clinical Trials and Cardiosource), Duke Clinical Research Institute (clinical trial steering committees), Slack Publications (as chief medical editor of Cardiology Today Intervention), and WebMD (CME steering committees). Additionally, D. L. Bhatt is a member of the advisory board of Medscape Cardiology; a member of the board of directors of Boston VA Research Institute and the Society of Chest Pain Centers; and chair of the American Heart Association Get With The Guidelines Science Subcommittee. He is the senior associate editor of the Journal of Invasive Cardiology. D. L. Bhatt served on the steering committee and as a national coordinator of TRILOGY ACS; he serves on the executive committee of PEGASUS TIMI 54; and he is the co-principal investigator of CHAMPION. K. Agrawal declares no competing interests.
Rights and permissions
About this article
Cite this article
Agrawal, K., Bhatt, D. Does prasugrel or ticagrelor suffice in patients with STEMI?. Nat Rev Cardiol 10, 121–122 (2013). https://doi.org/10.1038/nrcardio.2012.199
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrcardio.2012.199
This article is cited by
-
Safety and Efficacy of Cangrelor in Acute Coronary Syndromes: A Systematic Review and Network Meta-Analysis
American Journal of Cardiovascular Drugs (2024)
-
S2k-Leitlinie: Sekundärprophylaxe ischämischer Schlaganfall und transitorische ischämische Attacke (TIA) – Teil 1 und Teil 2
DGNeurologie (2022)
-
Optimizing the Use of Cangrelor in the Real World
American Journal of Cardiovascular Drugs (2017)