COMparison of Platelet reactivity following prAsugrel and ticagrelor loading dose in ST-Segment elevation myocardial infarctION patients: The COMPASSION study

Abstract

Prasugrel and ticagrelor are potent P2Y₁₂-ADP receptor antagonists which are superior to clopidogrel in acute coronary syndromes. To date no clinical trial directly compared these two drugs. Platelet reactivity correlates with ischemic and bleeding events in patients undergoing percutaneous coronary intervention. Recent pharmacological studies have observed a delayed onset of action of these two drugs in ST-segment elevation myocardial infarction (STEMI). We provide the first adequately powered pharmacological study comparing PR following ticagrelor and prasugrel loading dose (LD) in STEMI patients when the maximal biological effect is reached. In the present study, ticagrelor was associated with a lower rate of high on-treatment PR compared to prasugrel.

• Platelet reactivity
• prasugrel
• ST-segment elevation myocardial infarction
• ticagrelor
• VASP-index

Declaration of interest

The present work was supported by the Assistance Publique-Hôpitaux de Marseille. Laine Marc: lecture fees and consulting fees from AstraZeneca. Bonello Laurent: lecture fees from AstraZeneca, Lilly, Sanofi and research grant from Astrazeneca.