| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | P2Y12 Inhibitor Response By Patient Background Factors: An Exploratory Post Hoc Subgroup Analysis of the ACUTE-PRAS Study. |
| 掲載誌名 | 正式名：Journal of atherosclerosis and thrombosis 略 称：J Atheroscler Thromb ISSNコード：18803873/13403478 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Shigeru Fujimoto, Yasuyuki Iguchi, Hiroshi Yamagami, Masatoshi Koga, Ryo Itabashi, Yusuke Yakushiji, Kazuma Kowata, Naoto Kimura, Yuka Terasawa, Takahiro Shimizu, Yuichi Miyazaki, Koichi Oki, Osamu Masuo, Hideki Matsuoka, Shuji Arakawa, Toshihiro Ueda, Ryota Tanaka, Wataru Hashimoto, Satoru Abe, Go Kato, Taketoshi Furugori, Kazumi Kimura, |
| 発行年月 | 2026/03 |
| 概要 | AIM:To explore whether the antiplatelet effects of prasugrel and clopidogrel vary according to patient background factors in the ACUTE-PRAS study.METHODS:This was a post hoc, hypothesis-generating, exploratory analysis of the multicenter, open-label, randomized controlled ACUTE-PRAS study, in which 176 patients with acute atherothrombotic stroke or high-risk TIA received prasugrel or clopidogrel within 48 h of symptom onset. High platelet reactivity (HPR; platelet reaction units [PRU] ＞208) and absolute PRU were assessed on Day 5 in subgroups stratified by ABCD-GENE score, age, body mass index (BMI), chronic kidney disease (CKD), diabetes mellitus (DM), hypertension, dyslipidemia, time from stroke onset to treatment, National Institutes of Health Stroke Scale (NIHSS) score, and prior ischemic stroke.RESULTS:Patients with prasugrel had numerically lower rates of HPR than those with clopidogrel in the high-risk stratum of ABCD-GENE score ≥ 10 (OR 2.73, p = 0.076), and favorable trends in prasugrel were also observed for CKD (8.06, p = 0.012), age ＞75 years (5.02, p = 0.025), BMI ＜25 kg/m² (4.61, p = 0.012), dyslipidemia (4.73, p = 0.009), DM (3.86, p = 0.038), treatment initiation ≤ 24 h (3.31, p = 0.010), and NIHSS ≤ 3 (2.77, p = 0.036) or ≥ 4 (9.00, p = 0.025). Prasugrel also reduced PRU numerically more than clopidogrel across most subgroups, except in patients with BMI ≥ 25 kg/m2, treatment initiation ＞24 hours, or prior ischemic stroke, where only numerical differences were observed.CONCLUSIONS:Prasugrel provided favorable early platelet inhibition, particularly in subgroups characterized by advanced age, CKD, low BMI, metabolic comorbidities, or very early treatment start. |
| DOI | 10.5551/jat.66056 |
| PMID | 41780949 |