Effect of Alirocumab Added to High-Intensity Statin on Platelet Reactivity and Non-coding RNAs in AMI Patients: A Substudy of the PACMAN-AMI Trial.

Ueki, Yasushi; Häner, Jonas; Losdat, Sylvain; Gargiulo, Giuseppe; Shibutani, Hiroki; Bär, Sarah; Otsuka, Tatsuhiko; Kavaliauskaite, Raminta; Mitter, Vera; Temperli, Fabrice; Spirk, David; Stortecky, Stefan; Siontis, George; Valgimigli, Marco; Windecker, Stephan; Gutmann, Clemens; Koskinas, Konstantinos C; Mayr, Manuel; Raber, Lorenz (2023). Effect of Alirocumab Added to High-Intensity Statin on Platelet Reactivity and Non-coding RNAs in AMI Patients: A Substudy of the PACMAN-AMI Trial. (In Press). Thrombosis and haemostasis Thieme 10.1055/a-2156-7872

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The effect of the PCSK9 inhibitor alirocumab on platelet aggregation among patients with acute myocardial infarction (AMI) remains unknown. We aimed to explore the effect of alirocumab added to high-intensity statin therapy on P2Y12 reaction unit (PRU) among AMI patients receiving dual antiplatelet therapy (DAPT) with a potent P2Y12 inhibitor (ticagrelor or prasugrel). In addition, we assessed circulating platelet-derived non-coding RNAs (microRNAs and YRNAs).


This was a pre-specified, powered, pharmacodynamic substudy of the PACMAN trial, a randomized, double-blind trial comparing biweekly alirocumab (150mg) versus placebo in AMI patients undergoing percutaneous coronary intervention. Patients recruited at Bern University Hospital, receiving DAPT with a potent P2Y12 inhibitor, and adherent to the study drug (alirocumab or placebo) were analyzed for the current study. The primary endpoint was PRU at 4 weeks after study drug initiation as assessed by VerifyNow P2Y12 point-of-care assays.


Among 139 randomized patients, the majority of patients received ticagrelor DAPT at 4 weeks (57 [86.4%] in the alirocumab group vs. 69 [94.5%] in the placebo group, P=0.14). There were no significant differences in the primary endpoint PRU at 4 weeks between groups (12.5 [IQR, 27.0] vs. 19.0 [IQR, 30.0], P=0.26). Consistent results were observed in 126 patients treated with ticagrelor (13.0 [IQR, 20.0] vs. 18.0 [IQR, 27.0], P=0.28). Similarly, platelet-derived non-coding RNAs did not significantly differ between groups.


Among AMI patients receiving DAPT with a potent P2Y12 inhibitor, alirocumab had no significant effect on platelet reactivity as assessed by PRU and platelet-derived non-coding RNAs.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
04 Faculty of Medicine
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Ueki, Yasushi, Häner, Jonas, Gargiulo, Giuseppe, Shibutani, Hiroki, Bär, Sarah, Otsuka, Tatsuhiko, Kavaliauskaite, Raminta, Mitter, Vera Ruth, Temperli, Fabrice Gil, Spirk, David, Stortecky, Stefan, Siontis, Georgios, Windecker, Stephan, Koskinas, Konstantinos, Räber, Lorenz


600 Technology > 610 Medicine & health








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Date Deposited:

21 Aug 2023 12:10

Last Modified:

27 Sep 2023 14:02

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