Ricerc@Sapienza

BACKGROUND. Prasugrel and Ticagrelor are superior to Clopidogrel in ST-segment elevation myocardial infarction (STEMI) patients to reduce ischemic events. Patients with diabetes mellitus (DM) have increased platelet reactivity (PR) with a reduced response to antiplatelet agents in particular those on insulin treatment.
METHODS. We will perform a randomized trial to compare the PR following loading dose (LD) of Prasugrel and Ticagrelor in STEMI patients with DM and naïve for platelet P2Y12 receptor inhibitors. The PR assessments will be performed before LD administration and after 1-2-6-12 hours. The primary end-point is the superiority antiplatelet effect of Prasugrel vs Ticagrelor at 2 hours. Secondary end-points are PR measured at 1-6-12 hours. Finally a subanalysis will be performed between two study groups according to insulin treatment.
CONCLUSIONS. The results of our trial will be very important to know the antiplatelet effect in diabetic patient presented with ST-segment elevation myocardial infarction. While there are several studies assessing the antiplatelet effect of ticagrelor and prasugrel for STEMI, the current study focuses on diabetic patients, which is an important cohort with an higher risk of ischemic events.