The promise of effective P2Y12 platelet receptor pretreatment: Not crushed yet

Academic Article


  • Pre-treatment with intact oral clopidogrel and prasugrel tablets in a representative observational study is not associated with altered ischemic or bleeding outcomes in acute coronary syndrome (ACS) patients. Limited by cost, cangrelor, a rapidly acting intravenous P2Y12 platelet receptor inhibitor, achieved meaningful reductions in major adverse cardiovascular events (MACE) and stent thrombosis (ST) compared to oral clopidogrel pretreatment. Crushed prasugrel and ticagrelor (CP&T) administered orally achieve accepted thresholds of therapeutic platelet inhibition in one hour in approximately 2/3rds of patients compared to 1/3rd with intact oral tablets. A large, simple randomized trial should test whether CP&T pre-treatment could capture some of the potential outcome benefit of rapid P2Y12 inhibition at no incremental risk and cost.
  • Digital Object Identifier (doi)

    Author List

  • Chatterjee A; Hillegass WB
  • Start Page

  • 251
  • End Page

  • 252
  • Volume

  • 91
  • Issue

  • 2