The beneficial role of prasugrel, a P2Y12 receptor blocker, in several neurointerventional procedures has been reviewed clinically. Beyond its antiplatelet capacity, the potential neuroprotective mechanisms of prasugrel are poorly addressed experimentally. Relevant to the imbalance between neuro-inflammation and neuroprotective pathways in cerebral ischemia/reperfusion (I/R), our study evaluated the anti-ischemic potential of prasugrel treatment through tackling novel targets. Male Wistar rats were allocated into 2 sets; set 1 (I/R 60 min/3 days) to assess the neurological deficits/biochemical impact of prasugrel and set 2 (I/R 60 min/5 days) for evaluating short memory/morphological/immunoreactive changes. Each set comprised 4 groups designated as sham, sham + prasugrel, I/R, and I/R + prasugrel. Post-administration of prasugrel for 3 and 5 days reduced neurological deficit scores and improved the spontaneous activity/short term spatial memory using the Y-maze paradigm. On the molecular level, prasugrel turned off SUMO2/3-inhibitory kappa (Iκ)Bα, Ubc9 and nuclear factor kappa (NF-κ)B. Besides, it inhibited malondialdehyde (MDA) and inactivated astrocytes by downregulating the glial fibrillary acidic protein (GFAP) hippocampal immune-expression. Conversely, it activated its target molecule cAMP, protein kinase (PK)A, and cAMP response element-binding protein (CREB) to enhance the brain-derived nuclear factor (BDNF) hippocampal content. Additionally, cAMP/PKA axis increased the hippocampal content of deacetylator silent information regulator 1 (SIRT1) and the micro RNA (miR)-22 gene expression. The crosstalk between these paths partakes in preserving hippocampal cellularity. Accordingly, prasugrel, regardless inhibiting platelets activity, modulated other cellular components; viz., SUMO2/3-IκBα/Ubc9/NF-κB, cAMP/PKA related trajectories, CREB/BDNF and SIRT1/miR-22 signaling, besides inhibiting GFAP and MDA to signify its anti-ischemic potential.
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http://dx.doi.org/10.1016/j.taap.2021.115635 | DOI Listing |
Eur Heart J Cardiovasc Pharmacother
January 2025
Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan.
Aims: There were no previous studies comparing aspirin versus P2Y12 inhibitor monotherapy following short dual antiplatelet therapy (DAPT) after complex percutaneous coronary intervention (PCI).
Methods And Results: We conducted a prespecified subgroup analysis based on complex PCI in the 1-year results of the STOPDAPT-3 trial, which randomly compared 1-month DAPT followed by aspirin monotherapy (aspirin group) to 1-month prasugrel monotherapy followed by clopidogrel monotherapy (clopidogrel group). The main analysis in the present study was the 30-day landmark analysis.
Front Pharmacol
January 2025
Department of Pharmacy, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Background: Stroke is the leading cause of disability globally, with antiplatelet therapy being crucial for secondary prevention but also increasing bleeding risks. This requires careful dosage adjustments to balance thrombosis and bleeding risks.
Objective: This study compared the efficacy and safety of low-dose versus standard-dose antiplatelet therapy in stroke patients.
J Clin Exp Dent
December 2024
Unit of Oral Basic Investigation, UIBO School of Dentistry, Universidad El Bosque, Bogota, Colombia.
Background: This study aimed to compare the incidence of bleeding using two periodontal treatment protocols in patients with recent Acute Coronary Syndrome (ACS).
Material And Methods: This is an interim analysis of a double-blind controlled clinical trial evaluating two periodontal treatment schemes in patients with recent ACS treated with different dual antiplatelet regimens: Clopidogrel+ASA, Prasugrel+ASA and Ticagrelor+ASA. After randomisation six patients (22 quadrants) were treated with Scheme A (scaling and root planning-SRP) and six patients (21 quadrants) with Scheme B (ultrasonic scaling-US).
Neurosurg Rev
January 2025
Neurosurgical Service, Harvard Medical School, Beth Israel Deaconess Medical Center, 110 Francis Street, Boston, MA, 02215, USA.
Intracranial hemorrhages are highly concerning but underreported complications related to flow diversion (FD) treatment of intracranial aneurysms. Herein, we aimed to characterize these complications and the factors influencing their occurrence. We retrospectively reviewed patients treated with FD from 2013 to 2023 at a single U.
View Article and Find Full Text PDFCardiol J
January 2025
Department of Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy.
According to the ESC guidelines, cangrelor may be considered in P2Y12-inhibitor-naïve acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The aim of this review is to summarize available evidence on the optimal maintenance therapy with P2Y12 receptor inhibitor after cangrelor. Transitioning from cangrelor to a thienopyridine, but not ticagrelor, can be associated with a drug-drug interaction (DDI); therefore, a ticagrelor loading dose (LD) can be given any time before, during, or at the end of a cangrelor infusion, while a LD of clopidogrel or prasugrel should be administered at the time the infusion of cangrelor ends or within 30 minutes before the end of infusion in the case of a LD of prasugrel.
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