Gradual increase in thrombogenicity of juvenile platelets formed upon offset of prasugrel medication

摘要: In patients with acute coronary syndrome, dual antiplatelet therapy aspirin and a P2Y12 inhibitor like prasugrel is prescribed for one year. Here, we investigated how the hemostatic function of platelets recovers after discontinuation treatment. Therefore, 16 who suffered from ST-elevation myocardial infarction were investigated. Patients treated (100 mg/day, long-term) stopped taking (10 mg/day) Blood was collected at last day intake 1, 2, 5, 12 30 days later. Platelet in response to ADP normalized between five treatment cessation vitro addition reversible receptor antagonist ticagrelor fully suppressed regained activation response. Discontinuation resulted formation an emerging subpopulation ADP-responsive platelets, exhibiting high expression active integrin αIIbβ3. Two different mRNA probes, thiazole orange novel 5′Cy5-oligo-dT probe revealed that this consisted juvenile which progressively contributed platelet aggregation thrombus under flow. During offset, overall more reactive than older platelets. Interestingly, responsiveness both increased time, pointing towards residual inhibitory effect on megakaryocyte level. conclusion, gradual increase thrombogenicity due activity