Switching Acute Coronary Syndrome Patients From Prasugrel to Clopidogrel

ObjectivesThis study sought to assess the consequences of switching prasugrel to clopidogrel on platelet inhibition and clinical outcomes after an acute coronary syndrome (ACS).BackgroundMany ACS patients are switched from prasugrel to clopidogrel within the recommended 1-year duration of treatment.MethodsPlatelet reactivity was measured with the VerifyNow P2Y12 assay (Accumetrics, San Diego, California) in 300 ACS patients treated for 15 days with prasugrel 10 mg. Patients displaying low on-treatment platelet reactivity (LPR) and/or at high risk of bleeding were switched to clopidogrel 75 mg and tested again 15 days later. The rate of patients with high on-treatment platelet reactivity (HPR), P2Y12 reaction units (PRU) >208, and LPR (PRU