{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:24:10Z","timestamp":1790771050099,"version":"4.1.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Even among biomarker-negative patients undergoing elective percutaneous coronary intervention (PCI), periprocedural thrombotic and bleeding complications can lead to increased morbidity and mortality. Whether stronger platelet inhibition by an intensified oral loading strategy (ILS) before PCI impacts on outcomes among these patients in contemporary practice remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>This multicenter, randomized, assessor-blinded trial tested the hypothesis that in elective PCI prasugrel 60 mg (ILS) is superior to standard loading strategy with clopidogrel 600 mg regarding a composite primary end point of all-cause death, any myocardial infarction, definite\/probable stent thrombosis, stroke, or urgent vessel revascularization. After PCI, all patients were on clopidogrel 75 mg\/day and aspirin. The trial was terminated prematurely because of slower-than-expected recruitment and funding discontinuation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Of 781 patients included in the final analysis, 382 were assigned to ILS and 399 to standard loading strategy. At 30 days, the primary end point occurred in 66 patients (17.3%) assigned to ILS and 74 patients (18.6%) assigned to standard loading strategy (odds ratio, 0.92 [95% CI, 0.63\u20131.32];\n              <jats:italic>P<\/jats:italic>\n              =0.64). Any myocardial infarction and Bleeding Academic Research Consortium \u22652 bleeding rates were similar among ILS and standard loading strategy groups 16.2% versus 17.5%, odds ratio, 0.91 (95% CI, 0.62\u20131.32),\n              <jats:italic>P<\/jats:italic>\n              =0.62 and 4.2% versus 4.8%, odds ratio 0.87 (95% CI, 0.44\u20131.73),\n              <jats:italic>P<\/jats:italic>\n              =0.70, respectively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In biomarker-negative stable and unstable angina patients undergoing elective PCI, the trial did not find a conclusive difference in efficacy or safety. This observation should be interpreted in the context of wide CIs and premature termination of the trial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT02548611.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.119.008649","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T09:00:25Z","timestamp":1591952425000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Randomized Comparison of Intensified and Standard P2Y\n            <sub>12<\/sub>\n            -Receptor-Inhibition Before Elective Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8750-5567","authenticated-orcid":false,"given":"Julinda","family":"Mehilli","sequence":"first","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (J.M., M.B., M.T., S.G., M.Z., D.J., D.S., S.M.)."},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, all in Munich, Germany (J.M., M.R., D.J., D.S., S.S., A.K., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Baquet","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (J.M., M.B., M.T., S.G., M.Z., D.J., D.S., S.M.)."},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, all in Munich, Germany (J.M., M.R., D.J., D.S., S.S., A.K., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willibald","family":"Hochholzer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie und Angiologie II, Universit\u00e4res Herzzentrum Freiburg, Bad Krozingen, Germany (W.H., F.-J.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Mayer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Kreislauferkrankungen, Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (K.M., S.S., A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Tesche","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie und internistische Intensivmedizin, Klinikum Bogenhausen, Munich, Germany (C.T., E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Aradi","sequence":"additional","affiliation":[{"name":"Heart Centre Balatonf\u00fcred and Heart and Vascular Centre, Semmelweis University, Budapest, Hungary (D.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujun","family":"Xu","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (Y.X., U.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Thienel","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (J.M., M.B., M.T., S.G., M.Z., D.J., D.S., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Gschwendtner","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (J.M., M.B., M.T., S.G., M.Z., D.J., D.S., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda","family":"Zadrozny","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (J.M., M.B., M.T., S.G., M.Z., D.J., D.S., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jochheim","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (J.M., M.B., M.T., S.G., M.Z., D.J., D.S., S.M.)."},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, all in Munich, Germany (J.M., M.R., D.J., D.S., S.S., A.K., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Sibbing","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (J.M., M.B., M.T., S.G., M.Z., D.J., D.S., S.M.)."},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, all in Munich, Germany (J.M., M.R., D.J., D.S., S.S., A.K., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Sch\u00fcpke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Kreislauferkrankungen, Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany (K.M., S.S., A.K.)."},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, all in Munich, Germany (J.M., M.R., D.J., D.S., S.S., A.K., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Mansmann","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany (Y.X., U.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Klinik 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