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“Standard Therapy”

Clopidogrel 75 mg

“Clopidogrel arm”

Placebo LD

Clopidogrel 75 mg MD

+ Prasugrel placebo

“Prasugrel arm”

Prasugrel 60 mg LD

Prasugrel 10 mg MD

+ Clopidogrel placebo

Successful PCI with DES without major complication and NO GPIIb/IIIa use

Post-PCI VerifyNow P2Y12 Assay (PRU) 2 - 4 hours after 1st MD of clopidogrel 75 mg at day 1 post-PCI

Non-Responder

Clinical Follow-up and VerifyNow Assessment at 90 days, 180 days

Primary Endpoint: 6 month CV Death and MI

Yes

No

N ~ 8800

N = 1075

A

Random Selection

TRIGGER-PCI

“Clopidogrel arm”

Placebo LD

Clopidogrel 75 mg MD

+ Prasugrel placebo

“Prasugrel arm”

Prasugrel 60 mg LD

Prasugrel 10 mg MD

+ Clopidogrel placebo

Responder

PRU ≥ 208?

PRU ≥ 140?

N = 1075

B

N = 550

C

N = 550

D

E

Platelet function substudy:

VerifyNow Assessment at day 2 (2 – 4 h after 1st MD of study drug)

Courtesy of F.J. Neumann

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