• Mathieu Kerneis, Johanne Silvain, Jérémie Abtan, Marie Hauguel, Olivier Barthélémy, Laurent Payot, Delphine Brugier, Sophie Galier, Jean-Philippe Collet, and Gilles Montalescot.
• ACTION Study Group, Institut de Cardiologie, INSERM UMRS-1166, Pitié-Salpêtrière Hospital, AP-HP, Université Paris 6, Paris, France.
• Arch Cardiovasc Dis. 2015 Oct 1; 108 (10): 502-10.

BackgroundRecent studies have suggested that ticagrelor 90mg twice daily provides stronger platelet inhibition than prasugrel 10mg once daily in acute coronary syndrome patients undergoing percutaneous coronary intervention.ObjectivesTo compare the effects of ticagrelor 90 mg twice daily and prasugrel 10mg once daily on platelet reactivity in patients with ST-segment elevation myocardial infarction (STEMI), using: the VerifyNow(®) P2Y12 (VN-P2Y12) assay, expressed in P2Y12 reaction units (PRU); measurement of the vasodilator-stimulated phosphoprotein platelet reactivity index (VASP-PRI; %); and light transmission aggregometry (LTA), expressed as residual platelet aggregation (RPA; %).MethodsPlatelet reactivity was evaluated prospectively using the three assays 30 days after primary PCI in 118 patients with STEMI on a maintenance dose of prasugrel 10mg once daily (n=60) or ticagrelor 90mg twice daily (n=58).ResultsOn-treatment platelet reactivity, assessed by the VN-P2Y12 assay, was lower for ticagrelor compared with prasugrel (20.91 ± 4.59 PRU vs. 43.50±6.98 PRU; P=0.008) but was not significantly different when using the more specific VASP-PRI assay (13.05 ± 1.61% vs. 17.44 ± 1.97%; P=0.09) or RPA assessed by LTA (10.49 ± 1.44% vs. 7.20 ± 1.27%; P=0.09).ConclusionsThe difference in platelet reactivity between ticagrelor and prasugrel varies according to the platelet function test in patients with STEMI. The differences observed may be related more to the tests than to the drugs used.Copyright © 2015 Elsevier Masson SAS. All rights reserved.

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