Fractions of T receiver singer AMN-107 Tasigna with aspirin compared with no connection with a platelet aggregation inhibitor therapy in this patient group. Perhaps more importantly, both the cure and tested COMMIT 208 204 research-realistic hypotheses of relative risk reduction and the cuts that were consistent with these conservative estimates Sch. But found both the management of atherothrombosis with clopidogrel in high-risk patients and 205 clopidogrel and high-risk atherothrombotic isch Chemical stabilization, management and avoidance tested 203 researchers to the optimistic expectations of reducing risks and that a fraction of the expected benefits. The combination of clopidogrel and aspirin was compared with oral anticoagulation with vitamin K antagonists 105 and 106 to aspirin alone in the ACTIVE trial program. The prime Re endpoint in both trials was the composite of stroke, systemic embolism not CNS, MI, or stroke Rer death. The 6706 patients in clinical studies ACTIVE W was quite early by the Data Monitoring Committee because of clear evidence of the superiority of warfarin over aspirin and clopidogrel prevention of major vascular combinationof Stopped Ren events with Hnlichen rates of ‘severe bleeding. 105 The ACTIVE A trial involving patients with atrial fibrillation, the fi brillation than not f Rderf Were included hig for warfarin, the superiority of the combination of clopidogrel plus aspirin to aspirin alone in the Pr Convention severe vascular Re events in evidence provided. The difference is Haupts Chlich to a reduction of 28% compared to the incidence of Schlaganf Fill with clopidogrel, but this was a collaboration of t achieved an increase of major bleeding, including two 1,000 per year Verl EXTENSIONS of intracranial bleeding time. 106 The results of the study ACTIVE program rm confidence in the superiority of anticoagulation compared to treatment with antiplatelet agents to prevent Schlaganf Cases in patients with atrial fi brillation, but at the same time, the superiority of dual antiplatelet therapy with clopidogrel plus aspirin established on aspirin alone for this indication, which support a r the mechanics of the platelets in cardioembolic stroke. 4.3 Pharmacokinetics 4.3.1 prasugrel: Prasugrel is rapidly absorbed after oral ingestion and rapidly converted to its active metabolites, reaches peak levels within 30 minutes after ingestion. The absorption is not affected by food intake. The active metabolite has a half-life of 4 h and its renal excretion is the major route of elimination of metabolites. 210 The active metabolite of prasugrel is converted to inactive metabolites through methylation and conjugation of cysteine S. Early pharmacological studies with prasugrel in healthy subjects and 211 patients with stable coronary artery disease showed that prasugrel has a faster onset of action than 212 clopidogrel and produces a consistent and completely Requests reference requests getting ADPinduced inhibition of platelet aggregation. 211 212 The faster onset of action of prasugrel may be proteasom inhibitor cancer partly refl ECT with the conversion of liver to its active metabolites by CYP450 enzymes in a single step, which contrasts with that of clopidogrel, which durchl a two-stage process of converting liver Runs. 213 There is no evidence that polymorphisms in the CYP2C19 or the use of proton pump inhibitors interfere with the metabolism of prasugrel st Ren. 211 214 4.3.1 Efficiency.