prasugrel / Generic mfg. - LARVOL DELTA

Assessment of and Factors Contributing to Adequate Endothelization After Drug-Eluting Stent Implantation. (PubMed, Circ J) - "Functional protection against thrombus requires %ASC ≥67%, and plaque stabilization requires ≥90%. The use of ingenious DESs and prasugrel contributes to improved chronic adequate endothelization."

Journal • Cardiovascular • Hypertension • Thrombosis

Prasugrel inhibits TLR7-driven autoimmunity in systemic lupus erythematosus by acetylating cGAS. (PubMed, Nat Commun) - "We further demonstrate that cGAS deletion protects mice from lupus-like symptoms induced by the TLR7 agonist imiquimod (IMQ). Importantly, we report elevated plasma cyclic GMP-AMP (cGAMP) in SLE patients and identify it as a potential biomarker for predicting prasugrel response. Thus, our work elucidates the essential role of cGAS in SLE pathogenesis and presents prasugrel as a promising therapeutic option with immediate translational potential."

Journal • Immunology • Inflammatory Arthritis • Lupus • Systemic Lupus Erythematosus • CGAS • TLR7

Aspirin vs. Clopidogrel Monotherapy Beyond 1 Month After Percutaneous Coronary Intervention in Patients With Diabetes　- Prespecified Subgroup Analysis of the STOPDAPT-3 Trial. (PubMed, Circ J) - "From 30 days to 1 year after PCI, cardiovascular outcomes were similar between aspirin and clopidogrel regardless of diabetes. A nominal bleeding interaction was observed; given the exploratory and underpowered subgroup analyses, this finding should be interpreted cautiously."

Journal • Monotherapy • Cardiovascular • Diabetes • Hematological Disorders • Metabolic Disorders • Myocardial Infarction • Thrombosis

Contemporary Trends in High-Potency P2Y12 Receptor Inhibitor Use Among Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention. (PubMed, J Am Heart Assoc) - "Among patients with AMI undergoing PCI, the use of high-potency agents continues to rise. Prasugrel use increased notably after 2019, following the ISAR-REACT 5 (Prospective, Randomized Trial of Ticagrelor Versus Prasugrel in Patients With Acute Coronary Syndrome) trial and the European guideline updates. These findings reflect an evolving prescribing landscape of P2Y12 receptor inhibitors in contemporary practice."

Journal • Acute Coronary Syndrome • Cardiovascular • Chronic Kidney Disease • Genetic Disorders • Myocardial Infarction • Nephrology • Obesity • Renal Disease

Bridging Technique with a Stent Retriever for Iatrogenic Internal Carotid Artery Occlusion during Coil Embolization of a Ruptured Aneurysm. (PubMed, J Neuroendovasc Ther) - "After nasogastric administration of aspirin (200 mg) and prasugrel (20 mg), a Trevo NXT ProVue Retriever (6 × 37 mm) was deployed to restore antegrade flow. Six-month angiography confirmed complete healing of the dissection and durable patency of the ICA. In ruptured aneurysm cases complicated by intraoperative iatrogenic ICA occlusion, temporary flow restoration using a stent retriever can serve as a safe and effective bridging strategy to prevent ischemia until antiplatelet agents become effective, allowing delayed CAS without thromboembolic complications."

Journal • Cardiovascular • Hematological Disorders • Solid Tumor • Subarachnoid Hemorrhage • Thrombosis

Outcomes of Clopidogrel vs Potent P2Y12 Inhibitors in Patients With ACS and AF on OAC (SCCM 2026) - "However, limited data exist on the safety and efficacy of potent P2Y12 inhibitors, such as ticagrelor and prasugrel, when combined with OAC in this population. This study contributes to the small but growing body of literature evaluating combinations of OAC with clopidogrel versus potent P2Y12 inhibitors. It offers some insight into real-world clinical outcomes. Although no statistically significant safety or efficacy differences were observed, the numerically lower rate of MACE in the potent P2Y12 group may reflect enhanced antiplatelet efficacy, warranting further investigation."

Clinical • Acute Coronary Syndrome • Atrial Fibrillation • Cardiovascular • Hematological Disorders • Thrombosis

Clinical outcomes and missed benefits related to clopidogrel overuse in acute coronary syndrome. (PubMed, J Thromb Thrombolysis) - No abstract available

Clinical data • Journal • Acute Coronary Syndrome • Cardiovascular

ACUTE CORONARY SYNDROME WITH STENT THROMBOSIS: HEPARIN-INDUCED THROMBOCYTOPENIA WITH FALSE-NEGATIVE SEROTONIN RELEASE ASSAY IN A PATIENT ON TICAGRELOR (ACC 2026) - "Despite aspirin and ticagrelor, he developed recurrent chest pain within 5 hours...After switching to prasugrel, repeat SRA became positive. False-negative SRA results may occur with Ticagrelor. Awareness of this limitation and incorporation of alternative assays with clinical assessment are essential to avoid catastrophic complications from HIT"

Clinical • Acute Coronary Syndrome • Cardiovascular • Dyslipidemia • Hematological Disorders • Pulmonary Embolism • Respiratory Diseases • Thrombocytopenia • Thrombosis

TRENDS AND INSTITUTIONAL VARIATION IN HIGH-POTENCY P2Y12 INHIBITORS PRESCRIPTION AMONG PATIENTS WITH CHRONIC CORONARY SYNDROME UNDERGOING PERCUTANEOUS CORONARY INTERVENTION - AN ANALYSIS FROM THE NCDR CATH PCI REGISTRY (ACC 2026) - "Background: This analysis examines prescription patterns of high-potency P2Y12 inhibitors (ticagrelor or prasugrel) versus clopidogrel among patients with chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI) in the U.S. This is an observational analysis using the NCDR Cath-PCI registry including patients with CCS undergoing PCI from 2018 to 2024. About one-third of patients with CCS undergoing PCI received high-potency P2Y12 inhibitors at discharge, with wide variability across US institutions. This pattern was influenced by certain patient and procedural factors."

Clinical

TICAGRELOR VS PRASUGREL FOLLOWING PERCUTANEOUS CORONARY INTERVENTION FOR ACUTE MYOCARDIAL INFARCTION: A PROPENSITY-SCORE MATCHED ANALYSIS (ACC 2026) - "Among patients following PCI, prasugrel is associated with a significantly lower risk of adverse clinical events than ticagrelor. The benefits of fewer ischemic events with prasugrel did not occur at the expense of an increased risk of bleeding."

Cardiovascular • Ischemic stroke • Myocardial Infarction

TEG-6S PLATELET MAPPING ASSAY FOR IDENTIFYING HYPERCOAGULABILITY, ANTIPLATELET RESPONSE, AND 1-YEAR MACE PREDICTION IN ACS AND IS PATIENTS (ACC 2026) - "PA was lower with higher ASA doses (naïve: 70±29%, 81 mg: 28±32%, 325 mg: 17±25%; p<0.001) and with ticagrelor/prasugrel vs. clopidogrel (CLP) (45±30% vs. 69±32%; p<0.001). TEG6s-identified HYP, primarily driven by H-FCS, is linked to increased HPR and 1-year MACE. TEG6s testing shows promise for refining ischemic risk prediction and tailoring therapy, warranting further validation"

Clinical • Cardiovascular • Diabetes • Ischemic stroke • Metabolic Disorders • Nephrology • Renal Disease

INDIVIDUALIZED BLEEDING RISK WITH LOW-DOSE PRASUGREL VS. CLOPIDOGREL AFTER PCI: A CAUSAL FOREST-BASED MACHINE LEARNING APPROACH (ACC 2026) - "In several East Asian countries, low-dose (LD) prasugrel has been adopted in place of standard-dose prasugrel or ticagrelor. Individualized ARI estimation can inform P2Y12 inhibitor selection and improve safety, particularly in East Asians."

Clinical • Machine learning • Acute Coronary Syndrome • Cardiovascular

TEMPORAL TRENDS, PRACTICE VARIATION, AND CLINICAL OUTCOMES OF TICAGRELOR VS. PRASUGREL USE FOR ACUTE CORONARY SYNDROME IN THE US (ACC 2026) - "Ticagrelor use declined after ISAR-REACT 5 but remains predominant over prasugrel, with marked inter-hospital variation. Ticagrelor showed higher MACE risk and similar bleeding risk compared to prasugrel, consistent with ISAR-REACT 5."

Clinical • Clinical data • Acute Coronary Syndrome • Cardiovascular

TEG PLATELET MAPPING ASSAY IN A CASE OF RECURRENT IN-STENT THROMBOSIS IN A P2Y12 INHIBITOR NON-RESPONDER (ACC 2026) - "Relevant medications included aspirin 81 mg and clopidogrel 75 mg daily...The patient was discharged on apixaban 5 mg BID and ticagrelor 90 mg BID...The patient was transitioned to aspirin-dipyridamole BID, prasugrel 30 mg daily, and warfarin with an increase in ADP inhibition to 81% and no further thrombotic events. TEG platelet mapping is a useful tool in assessing adequate ADP inhibition in post catheterization patients with P2Y12 inhibitor resistance."

Clinical • Cardiovascular • Hematological Disorders • Myocardial Infarction • Thrombosis

ABCD-GENE SCORE AND BLEEDING IN POST-PCI PATIENTS: IMPLICATIONS FOR GUIDED DE-ESCALATION OF ANTIPLATELET THERAPY (ACC 2026) - "Therefore, the purpose of this study was to evaluate the association between a low ABCD-GENE score (< 10) and Bleeding Academic Research Consortium (BARC)-defined bleeding among patients treated with clopidogrel versus alternative (ALT) therapy (prasugrel or ticagrelor). The ABCD-GENE score was associated with any bleeding and major bleeding as defined by the BARC definition. Patients with a low score who received ALT therapy had significantly more bleeding compared to clopidogrel. Our findings support a bleeding avoidance strategy of guided de-escalation for those with a low ABCD-GENE score receiving ALT therapy."

Clinical • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Metabolic Disorders • Nephrology • Renal Disease • CYP2C19

Real-world adoption of the 2023 European Society of Cardiology guidelines regarding antiplatelet strategies in acute coronary syndromes: Insights from the European READAPT-2 survey. (PubMed, Int J Cardiol) - "Findings from READAPT-2 reveal a persistent gap between guideline awareness and clinical practice, highlighting the need for tailored implementation and education strategies to support a broader guideline uptake."

Journal • Real-world evidence • Acute Coronary Syndrome • Cardiovascular • Myocardial Infarction

REMAP-CAP: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community- Acquired Pneumonia (clinicaltrials.gov) - P3 | N=10000 | Recruiting | Sponsor: UMC Utrecht | Phase classification: P4 ➔ P3 | N=7100 ➔ 10000 | Trial completion date: Dec 2023 ➔ Dec 2025 | Trial primary completion date: Dec 2021 ➔ Dec 2023

Enrollment change • Phase classification • Trial completion date • Trial primary completion date • Infectious Disease • Influenza • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

REMAP-CAP: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community- Acquired Pneumonia (clinicaltrials.gov) - P4 | N=6800 | Recruiting | Sponsor: MJM Bonten | N=4000 ➔ 6800 | Trial completion date: Feb 2019 ➔ Jun 2022 | Trial primary completion date: Feb 2019 ➔ Dec 2021 | Initiation date: Dec 2015 ➔ Apr 2016

Enrollment change • Trial completion date • Trial initiation date • Trial primary completion date • Infectious Disease • Influenza • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

REMAP-CAP: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community- Acquired Pneumonia (clinicaltrials.gov) - P4 | N=7100 | Recruiting | Sponsor: MJM Bonten | Trial completion date: Jun 2022 ➔ Dec 2023

Trial completion date • Infectious Disease • Influenza • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

REMAP-CAP: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community- Acquired Pneumonia (clinicaltrials.gov) - P4 | N=4000 | Recruiting | Sponsor: UMC Utrecht

New P4 trial • Infectious Disease • Influenza • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

REMAP-CAP: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community- Acquired Pneumonia (clinicaltrials.gov) - P3 | N=10000 | Recruiting | Sponsor: UMC Utrecht | Trial completion date: Dec 2025 ➔ Feb 2028 | Trial primary completion date: Dec 2023 ➔ Feb 2026

Trial completion date • Trial primary completion date • Infectious Disease • Influenza • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

REMAP-CAP: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community- Acquired Pneumonia (clinicaltrials.gov) - P3 | N=20000 | Recruiting | Sponsor: UMC Utrecht | N=10000 ➔ 20000

Enrollment change • Infectious Disease • Influenza • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

Adjusting Antiplatelet Therapy Using P2Y12 Reaction Units in Endovascular Treatment of Unruptured Intracranial Aneurysms. (PubMed, Stroke Vasc Interv Neurol) - "Individualized antiplatelet therapy based on PRU measurements did not impact overall outcomes but reduced ischemic complications in complex endovascular treatments without increasing bleeding risks. Further validation is necessary."

Journal • Cardiovascular • Hematological Disorders • Ischemic stroke • Thrombosis • Vascular Neurology

SOLOPCI: Safety and Efficacy of Very Short DAPT in Older Patients Undergoing PCI (clinicaltrials.gov) - P3 | N=1700 | Recruiting | Sponsor: Vincent ROULE | Not yet recruiting ➔ Recruiting

Enrollment open • Monotherapy

TAILOR BLEED: Tailoring Bleeding Reduction Approaches in Patients Undergoing PCI (clinicaltrials.gov) - P4 | N=90 | Recruiting | Sponsor: University of Florida | Trial completion date: Mar 2026 ➔ Mar 2027 | Trial primary completion date: Jan 2026 ➔ Dec 2026

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