TRILOGY ACS which was presented at the ESC 2012 is a randomized, double blind study that included 10,300 patients and compared aspirin + cloplidogrel versus aspirin + prasugrel in patients admitted with acute coronary syndromes without ST-segment elevation and initially treated with a conservative strategy. The study concluded that the administration of prasugrel did not decrease ischemic events compared with clopidogrel.
Also at TCT 2012 the substudy of patients receiving invasive strategy where prasugrel reduced ischemic events combined rate, (relative risk reduction of 23%), with a tendency to increased bleeding was presented.
The current analysis also attempted to validate the impact of platelet function analysis and its relation to clinical events.
We used the VerifyNow® test with multiple measurements to monitor. The objective was to characterize the differences in platelet reactivity among patients treated with prasugrel 10 mg, prasugrel 5 mg, (> 75 and
Conclusión: Prasugrel has no clinical impact in patients with non-ST acute coronary syndromes managed clinically and the platelet reactivity test showed no relation to clinical events.
Comment: The analysis of platelet reactivity has not offered benefits in this and other studies, it appears not to be necessary in clinical practice. Prasugrel should be preferred over clopidogrel in those patients for whom an invasive strategy is planned.
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Paul Gurbel
2012-11-04
Original title: First Large-Scale Platelet Function Evaluation in an Acute Coronary Syndromes Trial – The TRILOGY ACS Platelet Function Sub-study.
