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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe Novel Antiplatelet Therapy in Patients Undergoing Nonurgent Percutaneous Coronary Interventions [INNOVATE PCI] trial compared with clopidogrel and elinogrel for platelet inhibition without increasing bleeding risk in patients who were undergoing elective percutaneous coronary intervention.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECoronary Artery Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EThrombotic Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EElinogrel, an investigational P2Y\u003Csub\u003E12\u003C\/sub\u003E inhibitor, showed potent antiplatelet activity in the phase II Randomized, Double-Blind, Active Controlled Trial to Evaluate Intravenous and Oral PRT060128 (elinogrel), a Selective and Reversible P2Y\u003Csub\u003E12\u003C\/sub\u003E Receptor 0Inhibitor, versus Clopidogrel, as a Novel Antiplatelet Therapy in Patients Undergoing Nonurgent Percutaneous Coronary Interventions (INNOVATE PCI) trial. Compared with clopidogrel, elinogrel provided greater and more rapid platelet inhibition without increasing bleeding risk in patients who were undergoing elective percutaneous coronary intervention (PCI).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EStronger platelet inhibition has the potential to improve ischemic outcomes but often at the cost of increased major bleeding. Reversible platelet inhibition may lessen the risk of bleeding complications. Elinogrel is the only antiplatelet agent to competitively and reversibly bind the P2Y\u003Csub\u003E12\u003C\/sub\u003E receptor. The agent can be administered both intravenously and orally, enabling acute and long-term use.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the INNOVATE PCI trial, 652 patients who were scheduled to undergo nonurgent PCI were randomly assigned to treatment with clopidogrel with an IV loading dose of 300 to 600 mg followed by 75 mg\/day, or elinogrel with an IV loading dose of 80 mg followed by oral elinogrel 50 mg, 100 mg, or 150 mg twice daily. After study enrollment began, the protocol was adjusted to eliminate the elinogrel 50-mg dose and increase the elinogrel IV loading dose to 120 mg.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EINNOVATE PCI was not powered for any specific endpoint but instead explored a range of efficacy, safety, and tolerability outcomes. Sunil Rao, MD, Duke University Medical Center, Durham, North Carolina, USA, reported findings from the INNOVATE PCI study.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EElinogrel provided a more rapid reduction in platelet aggregation compared with clopidogrel, with greater platelet inhibition at 30 minutes, 2 hours, and 20 hours after administration (p\u0026lt;0.025 for all comparisons). At 30 days, platelet inhibition remained greater with the elinogrel 100-mg and 150-mg oral doses compared with clopidogrel 75 mg.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThere were no significant differences in ischemic event rates between the elinogrel and clopidogrel groups at 24 hours or 120 days, suggesting similar acute and chronic efficacy. Biological activity was also comparable, with similar degrees of troponin elevation in both treatment groups. Elinogrel did not increase the risk of TIMI major or minor bleeding compared with clopidogrel at either time point.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EDyspnea was more common with elinogrel 100 mg (15.4%) and elinogrel 150 mg (12.1%) compared with clopidogrel (4.3%), but most cases were mild and transient. Patients in the elinogrel 100-mg and 150-mg groups were more likely to develop elevated liver transaminases (2% and 3.4%, respectively) compared with clopidogrel (0.5%).\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EFollowing the promising results of INNOVATE PCI, a phase III trial of elinogrel in patients with chronic coronary heart disease will launch in early 2011. The trial will enroll approximately 24,000 patients with a history of myocardial infarction (MI). Patients will be randomized to low-dose or high-dose elinogrel or placebo. The primary efficacy endpoint will be cardiovascular death, MI, or stroke.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/8\/21.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmp1p\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}