Evidence map›Paper›PMID 41780949›Full record

Trial reportJournal of atherosclerosis and thrombosis2026

P2Y

Shigeru Fujimoto, Yasuyuki Iguchi, Hiroshi Yamagami, Masatoshi Koga, Ryo Itabashi, Yusuke Yakushiji, Kazuma Kowata, Naoto Kimura, Yuka Terasawa, Takahiro Shimizu and 13 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of atherosclerosis and thrombosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Shigeru FujimotoDepartment of Medicine, Division of Neurology, Jichi Medical University.
Yasuyuki IguchiDepartment of Neurology, The Jikei University School of Medicine.
Hiroshi YamagamiDepartment of Stroke Neurology, NHO Osaka National Hospital.
Masatoshi KogaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Ryo ItabashiStroke Center, Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University.
Yusuke YakushijiDepartment of Neurology, Kansai Medical University.
Kazuma KowataInstitute of Brain and Blood Vessels, Mihara Memorial Hospital.
Naoto KimuraIwate Prefectural Central Hospital.
Yuka TerasawaDepartment of Neurology, Brain Attack Center Ota Memorial Hospital.
Takahiro ShimizuDepartment of Neurology, St.Marianna University School of Medicine.
Yuichi MiyazakiShonan Kamakura General Hospital.
Koichi OkiTokyo Saiseikai Central Hospital.
Osamu MasuoYokohama Municipal Citizen's Hospital.
Hideki MatsuokaNational Hospital Organization Kagoshima Medical Center.
Shuji ArakawaSteel Memorial Yawata Hospital.
Toshihiro UedaSt.Marianna University Toyoko Hospital.
Ryota TanakaDepartment of Medicine, Division of Neurology, Jichi Medical University.
Wataru HashimotoData Intelligence Department, Daiichi Sankyo Co., Ltd.
Satoru AbePrimary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd.
Go KatoPrimary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd.
Taketoshi FurugoriPrimary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd.
Kazumi KimuraDepartment of Neurology, Graduate School of Medicine, Nippon Medical School.
ACUTE-PRAS Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo explore whether the antiplatelet effects of prasugrel and clopidogrel vary according to patient background factors in the ACUTE-PRAS study.

methodsThis was a post hoc, hypothesis-generating, exploratory analysis of the multicenter, open-label, randomized controlled ACUTE-PRAS study, in which 176 patients with acute atherothrombotic stroke or high-risk TIA received prasugrel or clopidogrel within 48 h of symptom onset. High platelet reactivity (HPR; platelet reaction units [PRU] ＞208) and absolute PRU were assessed on Day 5 in subgroups stratified by ABCD-GENE score, age, body mass index (BMI), chronic kidney disease (CKD), diabetes mellitus (DM), hypertension, dyslipidemia, time from stroke onset to treatment, National Institutes of Health Stroke Scale (NIHSS) score, and prior ischemic stroke.

resultsPatients with prasugrel had numerically lower rates of HPR than those with clopidogrel in the high-risk stratum of ABCD-GENE score ≥ 10 (OR 2.73, p = 0.076), and favorable trends in prasugrel were also observed for CKD (8.06, p = 0.012), age ＞75 years (5.02, p = 0.025), BMI ＜25 kg/m² (4.61, p = 0.012), dyslipidemia (4.73, p = 0.009), DM (3.86, p = 0.038), treatment initiation ≤ 24 h (3.31, p = 0.010), and NIHSS ≤ 3 (2.77, p = 0.036) or ≥ 4 (9.00, p = 0.025). Prasugrel also reduced PRU numerically more than clopidogrel across most subgroups, except in patients with BMI ≥ 25 kg/m

conclusionsPrasugrel provided favorable early platelet inhibition, particularly in subgroups characterized by advanced age, CKD, low BMI, metabolic comorbidities, or very early treatment start.

Indexed as

Ischemic Attack, TransientPlatelet Aggregation InhibitorsPrasugrel HydrochloridePurinergic P2Y Receptor AntagonistsStrokeAgedClopidogrelFemaleHumansMaleMiddle AgedRisk FactorsClopidogrelPlatelet Aggregation InhibitorsPrasugrel HydrochloridePurinergic P2Y Receptor AntagonistsClopidogrelIschemic eventPlatelet reaction unitsPlatelet reactivityPrasugrel

Identifiers

PMID41780949
PMCPMC13246290

What Socratic holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.