High (100mg) Versus Standard (60mg) Loading Dose of Prasugrel in Patients With ST-elevation Myocardial Infarction (STEMI), Undergoing Primary Percutaneous Coronary Intervention (PCI)

High (100mg) Versus Standard (60mg) Loading Dose of Prasugrel in Patients With ST-elevation Myocardial Infarction (STEMI), Undergoing Primary Percutaneous Coronary Intervention (PCI)

This is a prospective, multi-center, non-randomized, controlled study in 2 sequential groups of P2Y12 inhibitor-naive consecutive STEMI patients undergoing primary PCI. Following aspirin 325 mg LD, patients will receive 60 mg or 100 mg of prasugrel, respectively. Platelet reactivity (PR)will be assessed at Hour 0 (before prasugrel's administration immediately prior to PCI) and at Hours 0.5, 1, 2, 4 thereafter. Platelet function testing (in PRU) will be performed with the VerifyNow (Accumetrics Inc., San Diego, CA, USA) P2Y12 function assay.

Inclusion Criteria:

• ST elevation myocardial infarction
• Pain onset <12 hours
• Age >18 and <75 years
• Written informed consent

Exclusion Criteria:

• history of stroke/transient ischemic attack
• oral anticoagulation
• hemodynamic instability
• platelet count <100000/μL
• hematocrit <30%
• creatinine clearance <30 ml/min
• severe hepatic dysfunction
• active bleeding
• weight <60 Kg
• periprocedural IIb/IIIa inhibitor administration