Coronary Artery Disease Clinical Trial
Official title:
Effect of Lower Loading Dose of Prasugrel Compared With Conventional Loading Dose of Clopidogrel and Prasugrel in Korean Coronary Artery Disease Patients Undergoing Coronary Angiography
Although prasugrel, recently available thienopyridine derivative, exhibits rapid and potent platelet inhibition, concerns of low on-treatment platelet reactivity have been suggested especially in East Asian ethnicities. The investigators compared the effect of lower loading dose of prasugrel with conventional loading dose of clopidogrel and prasugrel.
Although clopidogrel together aspirin has been a backbone of anti-platelet therapy in
coronary artery disease patients, clopidogrel has several limitations. It has delayed onset
of peak concentration and pharmacodynamic inter-patient response variability resulting in
high on-treatment platelet reactivity (HPR). Those demerits are known to be associated with
adverse cardiovascular outcomes.
Prasugrel has a more effective metabolism pathway than clopidogrel and exhibits more rapid
and potent platelet inhibition. Recent guidelines recommend prasugrel as a first line
antiplatelet agent or put precedence over clopidogrel for the patients with acute coronary
syndrome. However, there have been concerns of different pharmacodynamic and pharmacokinetic
response to prasugrel in East Asian ethnicities.
In addition, lower loading dose of prasugrel exhibited more potent pharmacodynamic effect
than clopidogrel 600 mg with comparable efficacy compared to conventional loading dose of
prasugrel in healthy Korean subjects.
The investigators compare the antiplatelet effect of lower loading dose of prasugrel 30 mg
with conventional loading dose of clopidogrel 600 mg and prasugrel 60 mg in Korean coronary
artery disease patients undergoing elective coronary angiography.
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Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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