Prasugrel Re-load Strategies

A higher degree of platelet inhibition remains the goal of peri-interventional and long-term
anti-thrombotic therapy in patients with coronary artery disease. In clinical practice,
patients undergoing percutaneous coronary intervention with stent implantation who are
already on clopidogrel therapy get re-loaded with clopidogrel. This is based on prior
observations showing that higher inhibition of platelet aggregation may be achieved by
giving a loading dose of clopidogrel in patients with coronary artery disease while on
chronic clopidogrel therapy. However, to date it is unknown if greater inhibition of
platelet aggregation can be achieved by adding a prasugrel loading dose in patients on
chronic prasugrel therapy. Therefore, understanding the pharmacodynamic implications of a
prasugrel re-load strategy in patients on already on chronic prasugrel therapy will be
useful.