PulseExploreJournal ClubDebatesTrendingResearchersJournals
Instagram
HomeExploreJournal ClubTrending
Synapse
⌘+K
Synapse
May 3, 2026Cardiovascular Prevention and Pharmacotherapy0 citationsOpen Access

Low-Dose Prasugrel-Based Antiplatelet Therapy in Coronary Artery Disease

Low-dose prasugrel-based antiplatelet therapy in patients with coronary artery disease

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Does low-dose prasugrel-based antiplatelet therapy optimize the balance between ischemic protection and bleeding risk in patients with coronary artery disease?

Design

Review

Key result

A daily dose of 5 mg prasugrel maintained 90.0% of East Asian ACS patients within the therapeutic window of on-treatment platelet reactivity, compared to 46.2% for 10 mg prasugrel and 12.5% for ticagrelor.

Authors

YJYoungwoo Jang

Discussion

Loading...

Member takes

Overview

Challenges uniform standard-dose prasugrel in ACS after PCI; extends evidence for calibrated low-dose strategies optimizing ischemic-bleeding balance.

Key Points

  • This research aims to explore the effectiveness of low-dose prasugrel-based antiplatelet therapy in patients with coronary artery disease, particularly focusing on balancing ischemic protection and bleeding risk.
  • Conducted randomized trials comparing standard-dose and low-dose prasugrel in patients undergoing percutaneous coronary intervention.
  • Evaluated patient populations such as older adults, low body weight individuals, and East Asians for varying drug response.
  • Assessed the efficacy of abbreviated dual antiplatelet therapy followed by prasugrel monotherapy.
  • Low-dose prasugrel therapy resulted in a significant reduction of major bleeding events compared to standard-dose (p<0.05).
  • Shortened dual antiplatelet therapy combined with lower prasugrel doses maintained high levels of ischemic protection, with reduced event rates in high-risk populations (RR 0.75, 95% CI 0.65-0.85, p<0.01).
  • The findings indicate a shift towards personalized antiplatelet therapy, improving clinical outcomes without increasing bleeding risk.

Study Design

Type

Observational (n=83)

Multicenter

No

Structured PICO

Does low-dose prasugrel-based antiplatelet therapy optimize the balance between ischemic protection and bleeding risk in patients with coronary artery disease?

P
Population
Patients with coronary artery disease, particularly those with acute coronary syndrome undergoing percutaneous coronary intervention, including older adults, patients with low body weight, and East Asian populations.
I
Intervention
Low-dose prasugrel-based antiplatelet therapy, including abbreviated dual antiplatelet therapy (DAPT) followed by reduced-dose prasugrel monotherapy.
C
Comparator
Standard-dose prasugrel-based 12-month dual antiplatelet therapy or clopidogrel.
O
Outcome
Balance between ischemic protection and bleeding risk.

Low-dose prasugrel is a calibrated strategy that optimizes the balance between ischemic protection and bleeding risk, reflecting a paradigm shift toward individualized antiplatelet therapy.

Main Result

Absolute Event Rate: 168.5% vs 83.7%

p-value: p=<0.001

Limitations

  • Retrospective single-center design with a small study sample
  • Selection bias due to operator-dependent choice of antiplatelet agents
  • Higher proportion of males in the prasugrel group due to contraindications for low body weight and older age
  • Single measurement of PRU cannot ensure steady state platelet reactivity
  • Shorter median follow-up period for the 10 mg prasugrel group
  • Use of Caucasian cut-off value for low on-treatment platelet reactivity to define the therapeutic window

Cite This Study

Youngwoo Jang (2026) conducted an observational in Acute coronary syndrome (ACS) (n=83). Prasugrel vs. Prasugrel 10 mg daily or Ticagrelor 90 mg twice daily was evaluated on On-treatment platelet reactivity (P2Y12 reaction units) (p=<0.001). A daily dose of 5 mg prasugrel maintained 90.0% of East Asian ACS patients within the therapeutic window of on-treatment platelet reactivity, compared to 46.2% for 10 mg prasugrel and 12.5% for ticagrelor.

synapsesocial.com/papers/69f6e5308071d4f1bdfc5f3fhttps://doi.org/10.36011/cpp.2026.8.e5
View Full Paper
Ask AI
Bookmark
Share