Comparison of therapy with ticagrelor, prasugrel or high clopidogrel dose in pci patients with high on treatment platelet reactivity and genotype variation. triplete reset trial

Response to Clopidogrel is widely variable and an early individuation of high on-treatment platelet reactivity (HTPR) could be associated with a better clinical outcome. Nevertheless, this strategies failed to demonstrate a clinical improvement [1,2]. Several data showed that the CYP2C19*2 loss-of-function allele is associated with a marked decrease in platelet response to Clopidogrel [3] and an impaired prognosis [4]. Prasugrel and Ticagrelor were more potent and faster than Clopidogrel [5,6] to reduce platelet reactivity (PR) but have not been examined in stable patients with HTPR. This trial is a single center, randomized and parallel-group study with blinded analyses and end-point adjudication. The protocol is conformed to the ethical guidelines of Helsinki Declaration as reflected in a priori approval by the institution's human research committee and written consent was obtained from all patients.