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TRILOGY ACS / Ancillary

TRILOGY ACS / Ancillary. Platelet function during extended prasugrel and clopidogrel therapy for patients with ACS treated without revascularization JAMA 2012 ; 308 : doi : 10.1001/jama.2012.17312. Gurbel PA et al. AHA 2012 . Méthodologie. Objectif

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TRILOGY ACS / Ancillary

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  1. TRILOGY ACS / Ancillary Platelet function during extended prasugrel and clopidogrel therapy for patients with ACS treated without revascularization JAMA 2012 ; 308 : doi : 10.1001/jama.2012.17312 Gurbel PA et al. AHA 2012

  2. Méthodologie Objectif • Évaluation de l’activité plaquettaire (VerifyNow P2Y12) et sa relation avec les évènements CV du post syndrome coronaire aigu ST- non revascularisé, traité exclusivement de façon médicale. Inclusion • 28% de la population initiale de l’étude princeps TRILOGY ACS • (n = 2564/9326) TRILOGY ACS Gurbel PA et al. AHA 2012

  3. Schéma de l’étude Clopidogrel n = 1278 Clopidogrel 75mg/j + Aspirine 100mg/j SCA ST- non revascularisé (n = 9326) < 75 ans = 7243 ≥ 75 ans = 2083 Réactivité plaquettaire (RP) évaluée par VerifyNow P2Y12 T0, H2, M1, M3, M6, M12, M18, M24, M30 RP forte, définie par valeur > 208 u Étude Ancillaire n = 2564 TRILOGY ACS Prasugrel * + Aspirine 100mg/jour Prasugrel n = 1286 * Selon âge et poids : 10 mg (< 75 ans + ≥ 60 kg) 5 mg (≥ 75 ans ou < 75 ans + < 60 kg) Gurbel PA et al. AHA 2012

  4. Caractéristiques Patients TRILOGY ACS Gurbel PA et al. AHA 2012

  5. Résultats TRILOGY ACS Gurbel PA et al. AHA 2012

  6. Résultats TRILOGY ACS Gurbel PA et al. AHA 2012

  7. Conclusion • Une réactivité plaquettaire élevée (> 208 u) est associée à un risque élevé d’évènements ischémiques • En post syndrome coronaire aigu ST-, le prasugrel diminue la réactivité plaquettaire plus fortement que le clopidogrel, mais sans influencer significativement le pronostic. TRILOGY ACS Gurbel PA et al. AHA 2012

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