prasugrel / Generic mfg. - LARVOL DELTA

Effects of Low-dose Ticagrelor vs. Clopidogrel in Stable Patients Undergoing Elective Percutaneous Coronary Intervention (clinicaltrials.gov) - P4 | N=50 | Recruiting | Sponsor: University of Florida | Trial completion date: Apr 2026 ➔ Apr 2027 | Trial primary completion date: Dec 2025 ➔ Dec 2026

Trial completion date • Trial primary completion date • Cardiovascular • Coronary Artery Disease • Myocardial Infarction

Impact of Area-Level Socioeconomic Deprivation on Post-PCI Outcomes Stratified by P2Y12 Inhibitor Therapy. (PubMed, JACC Adv) - "Higher SDI was associated with an increased risk of MAE with clopidogrel and bleeding with alternative therapy following PCI. Whether addressing socioeconomic disparities improves P2Y12 inhibitor-related outcomes remains to be determined."

Journal • Acute Coronary Syndrome • Cardiovascular • Hematological Disorders • Ischemic stroke • Myocardial Infarction • Thrombosis

Antiplatelet Therapy Combinations and Outcomes after Spontaneous Intracerebral Hemorrhage in the AHA Get With The Guidelines Registry (ISC 2026) - "The exposure was the type of APT defined as either monothrerapy (aspirin, clopidogrel, prasugrel, ticagrelor used alone), dual APT combinations involving these 4 medications, or no APT. In a large, diverse US cohort of ICH patients, increasing potency of antiplatelet therapy at the time of ICH was associated with higher mortality and a trend toward poor discharge disposition. Better knowledge of these relationships will be crucial in the management of antiplatelet associated ICH."

Cardiovascular • Cerebral Hemorrhage • Hematological Disorders

Efficacy and safety of off-label low-dose compared with standard-dose antiplatelet agents in patients with coronary heart disease: a meta-analysis. (PubMed, Open Heart) - "Off-label low-dose antiplatelet therapy reduces the risks of MI and minimal bleeding. It surpassed standard-dose clopidogrel and offered lower bleeding risks than prasugrel or ticagrelor, thus representing an effective secondary prevention strategy for Asian CHD."

Clinical • Journal • Retrospective data • Review • Acute Coronary Syndrome • Cardiovascular • Coronary Artery Disease • Heart Failure • Myocardial Infarction

TICAGRELOR VS PRASUGREL FOLLOWING PERCUTANEOUS CORONARY INTERVENTION FOR ACUTE MYOCARDIAL INFARCTION: A PROPENSITY-SCORE MATCHED ANALYSIS (ACC 2026) - "Abstract is embargoed at this time."

Cardiovascular • Myocardial Infarction

INDIVIDUALIZED BLEEDING RISK WITH LOW-DOSE PRASUGREL VS. CLOPIDOGREL AFTER PCI: A CAUSAL FOREST-BASED MACHINE LEARNING APPROACH (ACC 2026) - "Abstract is embargoed at this time."

Clinical • Machine learning

TEMPORAL TRENDS, PRACTICE VARIATION, AND CLINICAL OUTCOMES OF TICAGRELOR VS. PRASUGREL USE FOR ACUTE CORONARY SYNDROME IN THE US (ACC 2026) - "Abstract is embargoed at this time."

Clinical • Clinical data • Acute Coronary Syndrome • Cardiovascular

Unveiling the Hidden Risk: Ticagrelor-Induced Bradyarrhythmias and Conduction Complications in ACS Patients-Case Series. (PubMed, J Cardiovasc Dev Dis) - "Ticagrelor-induced bradyarrhythmias, although rare, represent an important and reversible adverse effect that clinicians should be aware of, particularly during the early post-ACS phase. Prompt recognition and drug withdrawal may prevent severe outcomes and avoid unnecessary interventions such as pacemaker implantation. Further studies are warranted to identify patient-specific risk factors predisposing to ticagrelor-related conduction disturbances."

Journal • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction • Pulmonary Disease • SLC29A1

Idiopathic esophageal submucosal hematoma after flow diverter stent placement for an unruptured intracranial aneurysm: illustrative case. (PubMed, J Neurosurg Case Lessons) - "Although rare, idiopathic esophageal submucosal hematoma should be considered a potential complication when a patient complains of chest pain after endovascular treatment. When antiplatelet therapy is required and no active bleeding is present, continuation of antiplatelet therapy can be a viable option under careful observation. https://thejns.org/doi/10.3171/CASE25495."

Journal • Cardiovascular • Hematological Disorders • Pain • Vascular Neurology

VERONICA: VerifyNow to Optimise Platelet Inhibition in Coronary Acute Syndrome (clinicaltrials.gov) - P4 | N=634 | Active, not recruiting | Sponsor: Fundación EPIC | Trial completion date: Dec 2025 ➔ Dec 2026 | Trial primary completion date: Dec 2025 ➔ Dec 2026

Trial completion date • Trial primary completion date • Acute Coronary Syndrome • Cardiovascular • Coronary Artery Disease • Myocardial Infarction

Single vs. Dual Antiplatelet Therapy in Elderly or HBR Patients Undergoing Percutaneous Intervention With DCB (PICCOLETO IV-EPIC 38) (clinicaltrials.gov) - P=N/A | N=576 | Recruiting | Sponsor: Fondazione Ricerca e Innovazione Cardiovascolare ETS | Not yet recruiting ➔ Recruiting | Trial completion date: Feb 2027 ➔ Feb 2028 | Trial primary completion date: Jan 2026 ➔ Jan 2028

Enrollment open • Trial completion date • Trial primary completion date • Acute Coronary Syndrome • Atherosclerosis • Cardiovascular • Coronary Artery Disease • Heart Failure • Myocardial Ischemia • Oncology

Plasma metabolomic profiling of patients with acute coronary syndrome treated with potent platelet inhibitors. (PubMed, Biomed Pharmacother) - "Ticagrelor and prasugrel are key antiplatelet agents used in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Reduced methionine and Met-SO levels could suggest lower oxidative stress. Moreover, diabetic patients showed a gut microbiome-related metabolic shift associated with a more ischemic profile."

Journal • Acute Coronary Syndrome • Cardiovascular • Metabolic Disorders • Pulmonary Disease

PCI-GULF: PCI With Guideline-Directed Medical Therapy for HFpEF Patients With Ischemic Cardiomyopathy (clinicaltrials.gov) - P=N/A | N=654 | Not yet recruiting | Sponsor: Nanjing First Hospital, Nanjing Medical University

New trial • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Heart Failure

PolyACS: A Polypill for Acute Coronary Syndrome (clinicaltrials.gov) - P2 | N=1000 | Recruiting | Sponsor: University of Texas Southwestern Medical Center | Phase classification: P3 ➔ P2

Phase classification • Acute Coronary Syndrome • Cardiovascular

ADEN: Assessment of an Early De-Escalation to a Low-potency Single Antiplatelet Therapy Guided by Genetics Versus a Systematic High-Potency Single Antiplatelet Therapy to Neutralize Bleeding Complications in Patients With High Bleeding Risk Beyond One Month After an Acute Coronary Syndrome (clinicaltrials.gov) - P3 | N=2468 | Recruiting | Sponsor: Assistance Publique - Hôpitaux de Paris | Trial completion date: Jan 2026 ➔ Jun 2027 | Trial primary completion date: Dec 2025 ➔ Jun 2027

Trial completion date • Trial primary completion date • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction

Precision PCI Registry (clinicaltrials.gov) - P=N/A | N=1643 | Active, not recruiting | Sponsor: University of Florida | Trial completion date: Dec 2025 ➔ Jul 2026 | Trial primary completion date: Dec 2025 ➔ Jul 2026

Trial completion date • Trial primary completion date • Cardiovascular • Coronary Artery Disease

Implementation of a CYP2C19 testing service to guide antiplatelet therapy (ANZCTR) - P=N/A | N=70 | Not yet recruiting | Sponsor: The University of Sydney

New trial • Cardiovascular • Coronary Artery Disease • CYP2C19

Safety and Efficacy Comparison of Ticagrelor versus Other P2Y12 Inhibitors in Combination with Oral Anticoagulants as a Part of DAPT/SAPT in Patients with Concomitant Atrial Fibrillation and Coronary Artery Disease: A Meta-Analysis. (PubMed, Ther Clin Risk Manag) - "We searched PubMed, Web of Science and ClinicalTrials.gov for randomized controlled trials (published from January 1, 1998, up to June 6, 2023; no language restrictions) comparing safety and efficacy of ticagrelor and DOACs or VKAs combination treatment arm with or without aspirin to other P2Y12 inhibitors treatment strategies. MACE was similar between ticagrelor versus clopidogrel (OR 1.00, 95% CI 0.54 to 1.86, I2=68.1%) and between ticagrelor versus prasugrel (OR 0.86, 95% CI 0.28 to 2.65, I2=0%). The use of ticagrelor is associated with significantly higher rates of bleeding when compared with clopidogrel in patients with concomitant atrial fibrillation and coronary artery disease."

Journal • Retrospective data • Acute Coronary Syndrome • Atrial Fibrillation • Cardiovascular • Coronary Artery Disease

Impact of shifting from routine use of ticagrelor to prasugrel in myocardial infarction patients after PCI: a nationwide cohort study. (PubMed, EuroIntervention) - "A shift from ticagrelor to prasugrel occurred between 2019 and 2022 among real-world MI patients post-PCI. Prasugrel was associated with reduced rates of MACE and MI and with similar bleeding rates compared with ticagrelor, supporting current guideline recommendations."

Journal • Cardiovascular • Myocardial Infarction

Capillary blood microsampling and LC-Orbitrap analysis for adherence monitoring of cardiovascular drugs: method development, cross-validation, and patient proof-of-concept using VAMS and Capitainer-B. (PubMed, Talanta) - "Amlodipine, atenolol, atorvastatin, bisoprolol, carvedilol, clopidogrel, diltiazem, lercanidipine, metoprolol, nebivolol, prasugrel, rosuvastatin, salicylic acid, simvastatin hydroxy acid, and verapamil were included. In a proof-of-concept involving 30 patients, finger-prick concentrations from VAMS and Capitainer-B were interchangeable, supporting the suitability of these adherence workflows but reference ranges for capillary blood remain necessary to enable routine clinical interpretation. In summary, this work established a reliable, LC-Orbitrap-based microsampling platform for monitoring adherence and identified stability issued amongst others that guide future method selection and development."

Journal • Cardiovascular

PICCOLETO IV: Single vs. Dual Antiplatelet Therapy in Elderly or HBR Patients Undergoing Percutaneous Intervention With DCB (clinicaltrials.gov) - P=N/A | N=576 | Not yet recruiting | Sponsor: Fondazione Ricerca e Innovazione Cardiovascolare ETS | N=416 ➔ 576 | Trial primary completion date: Oct 2025 ➔ Jan 2026

Enrollment change • Trial primary completion date • Acute Coronary Syndrome • Atherosclerosis • Cardiovascular • Coronary Artery Disease • Heart Failure • Myocardial Ischemia • Oncology

Guided De-escalation of Antiplatelet Treatment in Patients at High Atherothrombotic Risk Presenting With Acute Coronary Syndrome: A Post-Hoc Analysis of the TROPICAL-ACS trial. (PubMed, Eur Heart J Acute Cardiovasc Care) - "Early PFT-guided de-escalation from prasugrel to clopidogrel was safe across atherothrombotic risk categories, supporting individualized DAPT optimization in ACS patients with both low and high ischemic risk."

Journal • Retrospective data • Acute Coronary Syndrome • Cardiovascular • Diabetes • Metabolic Disorders • Myocardial Infarction • Nephrology • Renal Disease

Genotype-guided ticagrelor/prasugrel versus clopidogrel therapy in stroke patients with CYP2C19 loss of function alleles: a systematic review and meta-analysis. (PubMed, Pharmacogenomics) - "However, the bleeding events did not differ significantly (RR 0.91, 95% CI 0.65-1.27; p = 0.58) between the treatment groups. TIA/IS patients inheriting CYP2C19 LoF alleles taking ticagrelor/prasugrel may significantly optimize the overall clinical benefits compared to those who are taking clopidogrel by reducing composite vascular events and recurrent stroke without elevating the risk of bleeding events."

Journal • Retrospective data • Review • Cardiovascular • Ischemic stroke • CYP2C19

Explainable machine learning identifies immune-inflammatory biomarkers and therapeutic candidates in drug-resistant epilepsy. (PubMed, Sci Rep) - "Drug-gene interaction identified multiple repurposable compounds, with Prasugrel and Pentamidine having strong binding affinities in docking studies. This study reveals reproducible immune-related transcriptomic biomarkers of drug-resistant epilepsy, highlights actionable targets for therapeutic repurposing, and provides a framework for precision medicine approaches in epilepsy. Code and processed data are available at: https://github.com/Tayyab-Ijaz/EpilepsyBiomarkerDrugs."

Biomarker • Journal • CNS Disorders • Epilepsy • Inflammation • IL1B

Cost-Utility and Budget Impact Analysis of Pharmacogenetic-Guided Antiplatelet Therapy for Acute Coronary Syndrome in Thailand. (PubMed, Value Health Reg Issues) - "In Thailand's healthcare setting, PGx-guided ticagrelor is a dominant strategy for patients with post-PCI ACS. These findings support revising the National List of Essential Medicines to incorporate genotype-guided prescribing and enable broader access to precision medicine."

Biomarker • HEOR • Journal • Acute Coronary Syndrome • Cardiovascular • CYP2C19