Abstract 13950: A Head-to-Head Pharmacodynamic Comparison of Prasugrel versus Ticagrelor in Clopidogrel Treated Patients With Coronary Artery Disease: Results of a Prospective Randomized Study

Background: The comparative effects between the P2Y12 receptor inhibitors prasugrel and ticagrelor is a topic of growing interest. To date there are no studies comparing the pharmacodynamic (PD) impact of a loading dose (LD) and maintenance dose (MD) regimen of these agents in a cohort of all-comer patients on clopidogrel therapy. Methods: This was a prospective, randomized PD study of prasugrel vs ticagrelor in coronary artery disease (CAD) patients on maintenance clopidogrel (75mg/qd) therapy, in adjunct to aspirin (81mg/qd). Patients (n=110) were randomized to switch to prasugrel (60mg LD/10mg MD qd) or ticagrelor (180mg LD/90mg MD bid) for 1 week. PD assessments evaluating the acute (baseline, 30 min, 2 hrs, 24 hrs) and chronic (1 week) effects of therapy were performed. All patients initiated MD 24 hrs after LD of prasugrel (Group P) and ticagrelor (Group T1); a subgroup of T1 patients repeated the acute phase (first 24 hrs) starting the MD 12 hrs after LD (Group T2). The platelet reactivity index (P...