Abstract 18824: Impact of Diabetes Mellitus on the Pharmacodynamic Effects of Prasugrel and Ticagrelor After Switching From Clopidogrel in Patients With Coronary Artery Disease

Introduction: Patients with diabetes mellitus (DM) are at increased risk of atherothrombotic events due to their prothrombotic milieu and reduced response to antiplatelet agents, including clopidogrel. Prasugrel and ticagrelor have more prompt and potent antiplatelet effect than clopidogrel. However, limited data exist on the impact of DM status on the pharmacodynamic (PD) effects of these agents. Methods: We conducted a post-hoc analysis of a prospective randomized PD study (n=110) investigating the effects of prasugrel vs ticagrelor after switching from clopidogrel among DM patients with coronary artery disease. Overall, 55 patients were randomized to prasugrel (20 DM, 35 no-DM) and 55 to ticagrelor (22 DM, 33 no-DM). PD assessments included P2Y12 reaction units (PRU) by VerifyNow and platelet reactivity index (PRI) by VASP assessed at 4 time points: baseline (on clopidogrel), 30 min and 2h after loading dose (LD) and after 1 week of maintenance dose (MD) treatment. Results: Overall, platelet reactivity...