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A randomised trial on platelet function-guided de-escalation of antiplatelet treatment in ACS patients undergoing PCI. Rationale and design of the Testing Responsiveness to Platelet Inhibition on chronic Antiplatelet Treatment for Acute Coronary Syndromes (TROPICAL-ACS) Trial.
ieber J, Mudra H, Hausleiter J, Huber K, Neumann FJ, Koltowski L, Huczek Z, Mehilli J, Massberg S, TROPICAL-ACS Investigators Abstract Outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) have been significantly improved with the use of potent P2Y12 receptor inhibitors like prasugrel. While most of the ischaemic risk reduction for prasugrel versus clopidogrel was demonstrated in the early treatment period, the risk of bleeding became particularly prominent during the chronic course of therapy. It may therefore be a valid approach to substitute prasugrel for clopido...
Source: Thrombosis and Haemostasis - September 21, 2016 Category: Hematology Authors: Sibbing D, Aradi D, Jacobshagen C, Gross L, Trenk D, Geisler T, Orban M, Gori T, Hadamitzky M, Merkely B, Kiss RG, Komócsi A, Dézsi CA, Thalmeier A, Löw A, Holdt L, Teupser D, Ince H, Felix SB, Parma R, Malek L, Horstkotte J, Baylacher M, Schwinger R, Tags: Thromb Haemost Source Type: research

Prior chronic clopidogrel therapy is associated with increased adverse events and early stent thrombosis.
Abstract Despite the growing use of clopidogrel, limited data exist regarding the prognostic significance of chronic clopidogrel therapy in patients sustaining acute coronary syndrome (ACS). Our aim was to determine whether patients sustaining ACS while on chronic clopidogrel therapy have a worse prognosis than clopidogrel-naïve patients. A total of 5,386 consecutive ACS patients were prospectively characterised and followed-up for 30 days. Of them, 680 (13 %) were treated with clopidogrel prior to the index ACS. Major adverse cardiovascular events (MACE) were defined as death, recurrent ACS, stroke and/or sten...
Source: Thrombosis and Haemostasis - October 8, 2015 Category: Hematology Authors: Asher E, Fefer P, Sabbag A, Herscovici R, Regev E, Mazin I, Shlomo N, Zahger D, Atar S, Hammerman H, Polak A, Beigel R, Matetzky S, PLATIS (Platelets and Thrombosis in Sheba) Study Group Tags: Thromb Haemost Source Type: research