prasugrel / Generic mfg. - LARVOL DELTA

Risk of bleeding in chronic lymphocytic leukemia patients in remission treated with covalent Bruton tyrosine kinase inhibitors and contemporary anticoagulant or antiplatelet drugs: Real-world data analysis (ASH 2025) - "The study population was divided into two main cohorts: 1) Cohort 1: CLLpatients in remission treated with covalent BTKi (ibrutinib/acalabrutinib/zanubrutinib) concurrentlytreated with AC (rivaroxaban/apixaban/edoxaban/dabigatran) or AP agents (acetylsalicylicacid/clopidogrel/prasugrel/ticagrelor/ticlopidin), and 2) Cohort 2: CLL patients in remission treated withcovalent BTKi (ibrutinib/acalabrutinib/zanubrutinib) not concurrently treated with AC or AP agents.Cohort 1 was further subdivided into two groups: those treated only with AC and those treated only withAP. CLL patients in remission treated with covalent BTKis experience a significant risk ofbleeding events. This risk is substantially elevated when covalent BTKis therapy is combined with eitheranticoagulant or antiplatelet agents. Notably, our findings indicate no discernible difference in bleedingrisk between AC or AP agents when used concurrently with covalent BTKis."

Clinical • Real-world • Real-world evidence • Chronic Lymphocytic Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia

PRMT1 drives platelet metabolic reprogramming, thromboinflammation, and antiplatelet drug resistance (ASH 2025) - "Interestingly, PRMT1-highplatelets cannot respond to P2Y12 inhibition with prasugrel due to PRMT1-mediated attenuation ofmitochondrial respiratory capability... Together, These findings elucidate a novel mechanism underlying platelet hyperactivity andantiplatelet resistance in metabolic diseases, and identify PRMT1 as a potentially promising therapeutictarget in thromboinflammatory disorders."

Diabetes • Infectious Disease • Inflammation • Metabolic Disorders • Septic Shock • CXCR3 • DUSP4 • IL1B • PRMT1 • RBM15 • RUNX1 • SUCNR1

Registry on Augmented Antithrombotic Treatment Regimens for Patients With Arterial Thrombotic APS (clinicaltrials.gov) - P=N/A | N=150 | Recruiting | Sponsor: McMaster University | Trial completion date: Dec 2027 ➔ Dec 2029 | Trial primary completion date: Jul 2027 ➔ Jul 2029

Trial completion date • Trial primary completion date • Cardiovascular • Genetic Disorders • Hematological Disorders • Thrombosis

Relationship between high platelet reactivity with Prasugrel and clinical events after percutaneous coronary intervention in patients with diabetes mellitus: A PENDULUM registry substudy. (PubMed, J Cardiol) - "In patients with DM, HPR with prasugrel was not associated with MACCE or major bleeding, whereas MACCE tended to be increased in those without DM."

Journal • Diabetes • Metabolic Disorders

Optimal Antiplatelet Therapy in Patients After Coronary Artery Bypass Grafting. (OPTIMUS-CABG Trial) (clinicaltrials.gov) - P3 | N=1703 | Recruiting | Sponsor: Dolnośląskie Centrum Chorób Serca im.prof. Zbigniewa Religi MEDINET Sp. z o.o. | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • Coronary Artery Disease

Comparative Effectiveness of Clopidogrel vs. Potent P2Y12 Inhibitors in CYP2C19 Normal Metabolizers Following Percutaneous Coronary Intervention: A Real-World Cohort Study. (PubMed, Br J Clin Pharmacol) - "Among patients with MI with CYP2C19 NM undergoing percutaneous coronary intervention, the use of potent P2Y₁₂ inhibitors was associated with a reduced risk of thrombotic events at 1 year compared to clopidogrel. These findings indicate genotype-guided de-escalation strategies warrant further investigation across diverse clinical settings."

HEOR • Journal • Real-world evidence • Cardiovascular • Gastroenterology • CYP2C19

1-month safety results in a randomized controlled trial (COATING) evaluating a surface-modification flow diverter (p64-MW-HPC) under single antiplatelet treatment. (PubMed, J Neurointerv Surg) - "COATING is the first RCT to evaluate an SM FD (p64-MW-HPC) under SAPT and shows favorable safety at 1 month."

Journal • Cardiovascular • Vascular Neurology

Effect of Proton Pump Inhibitors in Patients Undergoing Percutaneous Coronary Intervention With Aspirin-Free Strategy. (PubMed, JACC Asia) - P4 | "We compared outcomes between patients with and without PPI prescription in the STOPDAPT-3 trial enrolling patients undergoing PCI stratified by the no-aspirin (1-month prasugrel monotherapy followed by clopidogrel monotherapy: n = 2,909 [acute coronary syndrome: n = 2,170, high bleeding risk: n = 1,580]) and the aspirin (1-month dual antiplatelet therapy followed by aspirin monotherapy: n = 2,914 [acute coronary syndrome: n = 2,171, high bleeding risk: n = 1,566]) strategies at 1 year. Incidence of major bleeding was not different between the groups regardless of the no-aspirin and aspirin strategies (5.5% vs 3.3%, P = 0.150, and 6.9% vs 4.3%, P = 0.278) PPI use was associated with higher risks of cardiovascular events and mortality without decreasing major bleeding in patients undergoing PCI with aspirin-free P2Y12 inhibitor monotherapy. (ShorT and OPtimal duration of Dual AntiPlatelet Therapy after everolimus-eluting cobalt-chromium stent-3 [STOPDAPT-3];..."

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

The efficacy and safety of prasugrel in acute coronary syndrome: a propensity-matched Korean cohort study focused on age and weight of patients. (PubMed, BMC Cardiovasc Disord) - P=N/A | "In this Korean PS-matched ACS cohort, prasugrel, even at a reduced dose, was associated with superior effectiveness compared to clopidogrel without a significant increase in bleeding risk. These benefits were consistently observed in ELB patients. Our findings support the use of prasugrel in selected high-risk populations and offer guidance for clinical practice."

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

Impact of Body Mass Index on Clinical Outcomes in Myocardial Infarction Patients Undergoing Coronary Stenting with Dual Antiplatelet Therapy. (PubMed, Biomedicines) - "Background: Dual antiplatelet therapy (DAPT), combining aspirin with a P2Y12 receptor inhibitor (P2Y12i), remains central to the management of acute myocardial infarction (MI), especially in patients undergoing percutaneous coronary intervention (PCI)...Patients were stratified into clopidogrel-based (n = 44,480) and potent P2Y12i-based (prasugrel or ticagrelor; n = 7639) DAPT cohorts... In patients with MI undergoing PCI, elevated BMI was paradoxically associated with more favorable short-term outcomes, including reduced mortality. Potent P2Y12i therapy demonstrated a consistent benefit across BMI categories, supporting its broad application irrespective of body mass."

Clinical data • Journal • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction

DOSE: Randomized Comparison of Radiation Exposure to Operators in Coronary Intervention Between Right Radial and Left DRA (clinicaltrials.gov) - P=N/A | N=1010 | Completed | Sponsor: Yonsei University | Active, not recruiting ➔ Completed | Trial completion date: Dec 2025 ➔ Jul 2025 | Trial primary completion date: Dec 2025 ➔ Mar 2025

Trial completion • Trial completion date • Trial primary completion date

The Impact of Cangrelor in the UK for the Treatment of STEMI Patients with Gastric Absorption Issues Undergoing Percutaneous Coronary Intervention. (PubMed, J Clin Med) - "Oral P2Y12 inhibitors (clopidogrel, prasugrel, and ticagrelor), glycoprotein IIb/IIIa inhibitors (eptifibatide and tirofiban), and aspirin and heparin alone were included as base case comparators. The introduction of cangrelor is estimated to lead to 314 fewer hospital days and 190 clinical events avoided over 5 years. Introducing cangrelor to STEMI patients with gastric absorption issues undergoing PCI in the UK is estimated to generate a small cost saving and reduced length of stay for some patients."

Journal • Cardiovascular • Myocardial Infarction

Genetic Determinants of Response to P2Y12 Inhibitors and Clinical Implications. (PubMed, Heart Fail Clin) - "The CYP2C19 enzyme metabolizes clopidogrel, a prodrug, to its active form. Prasugrel or ticagrelor is recommended in those with an LoF allele as neither is affected by CYP2C19 genotype. Although data demonstrate improved outcomes with a CYP2C19-guided approach to P2Y12 inhibitor selection, genotyping has not yet been widely adopted in clinical practice."

Journal • Review • Acute Coronary Syndrome • Cardiovascular • CYP2C19

Ticagrelor versus Prasugrel in Patients with Diabetes Mellitus and Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Randomized Comparison from the TUXEDO-2 Trial (AHA 2025) - "Patients with diabetes mellitus and angiographically confirmed MVD were randomized 1:1 to either SupraflexCruz SES or Xience EES and to receive either ticagrelor or prasugrel (factorial design), each in combination with aspirin, as part of DAPT. TUXEDO-2 will help address the question of whether there are differences in clinical outcomes between ticagrelor or prasugrel in patients with diabetes and MVD undergoing PCI using contemporary drug eluting stents."

Clinical • Late-breaking abstract • Acute Coronary Syndrome • Cardiovascular • Coronary Artery Disease • Diabetes • Metabolic Disorders

P2Y12R Blockade Attenuates LPS-Induced Acute Lung Injury Associated with Suppression of Inflammasome-Mediated Pyroptotic Signaling. (PubMed, Drug Des Devel Ther) - "This study investigates the effects of P2Y12R antagonists including Clopidogrel, Prasugrel, and Ticagrelor on LPS-induced ALI in mice, focusing on inflammation and pyroptosis. TEM analysis showed reduced organelle damage in treated groups. P2Y12R antagonists, particularly Ticagrelor, attenuate lung injury and were associated with suppression of the NLRP3/caspase-1/GSDMD pyroptotic signaling axis."

Journal • Acute Lung Injury • Inflammation • Respiratory Diseases • IL1B • IL6 • MPO • NLRP3 • TNFA

Streamlining Post-PCI Medication Access to Improve DAPT Adherence and Outcomes. (PubMed, JACC Case Rep) - "Leveraging hospital pharmacy resources for outpatient PCI patients ensures timely access to dual antiplatelet therapy, improves adherence, and reduces adverse cardiovascular events."

Journal • Cardiovascular • Hematological Disorders • Thrombosis

Reversible cerebral vasoconstriction syndrome with delayed vasospasms and subdural hematoma after cardiac transplantation: a case report. (PubMed, Front Cardiovasc Med) - "Management included withdrawal of tacrolimus and initiation of oral verapamil and prasugrel. This case highlights that RCVS can present with a subdural hematoma before the onset of delayed vasospasm after cardiac transplantation. Repeated cerebrovascular evaluations are crucial for timely diagnosis and management in post-transplant patients with unexplained headaches or intracranial hemorrhage."

Journal • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Ischemic stroke • Pain • Subarachnoid Hemorrhage • Transplantation

ASSESSING POST-OPERATIVE PAIN AFTER MULTI-PORT OR SINGLE-PORT ROBOTIC-ASSISTED LAPAROSCOPIC PROSTATECTOMY DEMONSTRATES LOW NARCOTIC REQUIREMENTS AND FEASIBLITY TO ELIMINATE ROUTINE OPIOID PRESCRIBING (SUO 2025) - "The cohort was predominantly white race (86.6%) with a minority using anticoagulation (27 aspirin, 4 apixaban, 1 clopidogrel, 1 prasugrel). Patients undergoing RALP exhibited low pain medication needs with most patients using no more than a few tablets of narcotic, and no ER presentations were noted for pain control. This suggests default prescribing is likely unnecessary, and when narcotics are prescribed, these could be safely limited in frequency and quantity. Both SP and Xi cohorts demonstrated similar pain measures, though there were small improvements in the SP cohort most notably a faster time to first bowel movement."

Addiction (Opioid and Alcohol) • Constipation • Gastroenterology • Gastrointestinal Disorder • Genito-urinary Cancer • Immunology • Pain • Prostate Cancer • Solid Tumor

Human Plasma Derived Antithrombin (Atenativ) in Heparin-Resistant Cardiac Surgery Patients: Protocol Update for an Ongoing Phase 3, Double-Blind, Placebo-Controlled, Multicenter Study (ASH 2024) - P3 | "Exclusion criteria include patients receiving anticoagulant therapies (warfarin, direct oral anticoagulants, ticlopidine, prasugrel, clopidogrel, ticagrelor or a glycoprotein IIb/IIIa antagonist) directly before the study, pre-existing coagulopathy, renal insufficiency (serum creatinine level >1.5 mg/dL), a history of bleeding problems or a laboratory-diagnosed bleeding disorder. Target enrollment is ~120 patients. The findings of this study could confirm the efficacy and safety of AT concentrate in re-establishing and maintaining heparin responsiveness for acquired AT deficiency in patients undergoing CPB."

Clinical • P3 data • Surgery • Cardiovascular • Hematological Disorders • Nephrology • Renal Disease • Thrombosis

Acute Inferolateral STEMI as an Initial Presentation of Polycythemia Vera with Recurrent Coronary Thrombosis Despite Triple Therapy (AHA 2025) - "Despite triple therapy (aspirin, prasugrel, apixaban), ECG indicated lateral STEMI (Figure 1B). Prompt recognition and management of PV are critical. Early hematology involvement and initiation of cytoreductive measures, such as phlebotomy and hydroxyurea, to keep hematocrit <45% could reduce the risk of recurrent thrombotic events."

Cardiovascular • Diabetes • Hematological Disorders • Hypertension • Hypotension • Metabolic Disorders • Nephrology • Polycythemia Vera • Pulmonary Disease • Renal Disease • Thrombosis • JAK2

Aspirin or P2Y12 inhibitor monotherapy in atherosclerotic cardiovascular disease? (PubMed, Eur Heart J) - "Special attention is given to the practical challenges and considerations surrounding the use of aspirin vs P2Y12 inhibitor monotherapy, including interindividual variability in drug response, side effects, costs, and real-world implementation. By evaluating the strengths and limitations of these treatment options, this article aims to guide clinicians in optimizing the selection of single antiplatelet strategies for long-term secondary prevention in patients with atherosclerotic disease."

Journal • Monotherapy • Atherosclerosis • Cardiovascular

Early Aspirin Withdrawal after Percutaneous Coronary Intervention in Acute Coronary Syndromes With and Without ST-Segment Elevation: Results from the NEO-MINDSET trial (AHA 2025) - "We evaluated early aspirin withdrawal effects on ischemic and bleeding outcomes according to ACS presentation.Study Design and Pre-specified analysis of the NEO-MINDSET trial according to ACS presentation (STEMI and NSTE-ACS)Sample Size: 3,410 patients: STEMI (n=1,058 monotherapy, n=1,061 DAPT); NSTE-ACS (n=654 monotherapy, n=637 DAPT).Population Studied: ACS patients undergoing successful PCI with drug-eluting stents within 4 days of admission.Intervention: Potent P2Y12 inhibitor monotherapy (prasugrel or ticagrelor) with immediate aspirin discontinuation versus standard DAPT with a potent P2Y12 inhibitor for 12 months.Power Calculations: Not performed for this prespecified analysis.Primary Endpoints: Co-primary endpoints were: 1) the composite of all-cause death, myocardial infarction, stroke, or urgent target-vessel revascularization; and 2) Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding.Secondary Endpoints: Individual components of the..."

Acute Coronary Syndrome • Cardiovascular • Hematological Disorders • Myocardial Infarction • Thrombosis

Intensive antithrombotic therapy is necessary for long-term treatment in patients with symptomatic peripheral artery disease after acute myocardial infarction. (PubMed, Sci Rep) - "This post hoc analysis of PRAGUE-18, a multicenter, randomised trial comparing prasugrel versus ticagrelor in primary PCI, analysed the effect of symptomatic PAD and intensity of antithrombotic therapy on the prognosis of AMI patients treated with primary percutaneous coronary intervention (PCI). All-cause mortality significantly increased only in subgroup of patients who de-escalated to clopidogrel [6.37 (2.16-18.84), p = 0.001] as opposed to those who did not [3.02 (0.72-12.61), p = 0.13]. These findings suggest that long-term intensive antithrombotic therapy may be particularly important for post-AMI patients with concomitant symptomatic PAD and warrant further investigation."

Clinical • Journal • Cardiovascular • Myocardial Infarction • Peripheral Arterial Disease

TAILOR BLEED: Tailoring Bleeding Reduction Approaches in Patients Undergoing PCI (clinicaltrials.gov) - P4 | N=90 | Recruiting | Sponsor: University of Florida | Trial completion date: Dec 2025 ➔ Mar 2026 | Trial primary completion date: Jul 2025 ➔ Jan 2026

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

Comparative Effects of P2Y12 Inhibitors on Thrombus Biology and Inflammatory Responses in Atherothrombotic Cardiovascular Disease: A Systematic Review of Randomized Controlled Trials. (PubMed, Cureus) - "These trials examined ticagrelor, prasugrel, cangrelor, and genotype-guided strategies in comparison to clopidogrel, assessing outcomes such as inflammatory cell infiltration, platelet reactivity, and myocardial reperfusion parameters. Collectively, the available evidence provides preliminary mechanistic support for the hypothesis that certain P2Y12 inhibitors may exert anti-inflammatory and thrombus-modifying effects beyond their platelet-inhibiting effects. Larger, standardized, and mechanistically focused trials are warranted to validate these findings and guide precision-based antiplatelet therapy in cardiovascular disease."

Journal • Review • Acute Coronary Syndrome • Cardiovascular • Inflammation • Thrombosis • MPO