ticagrelor + prasugrel + clopidogrel

This entry refers to the antiplatelet regimen evaluated in the RAPID-MANAGE clinical trial (NCT02044146) conducted by the Ottawa Heart Institute Research Corporation. The study compares a personalized antiplatelet strategy against standard care in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). The personalized approach utilizes pharmacogenomic testing for CYP2C19*2 and *3 genetic variants combined with clinical demographic factors to select between clopidogrel and prasugrel for patients at high risk for high on-treatment platelet reactivity. This is compared against standard therapy consisting of ticagrelor or clopidogrel. All three agents—ticagrelor, prasugrel, and clopidogrel—are small molecule P2Y12 receptor inhibitors that prevent platelet aggregation. Clopidogrel and prasugrel are thienopyridine prodrugs requiring metabolic activation, while ticagrelor is a direct-acting cyclopentyl-triazolopyrimidine.

Other names

Antiplatelet therapy