De-Escalation of Antiplatelet Treatment in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Review of the Current Literature
In acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), treatment with the P2Y<sub>12</sub> inhibitors ticagrelor or prasugrel is recommended over clopidogrel due to a better efficacy, albeit having more bleeding complication. These higher bleeding...
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Format: | Article |
Language: | English |
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MDPI AG
2020-09-01
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Series: | Journal of Clinical Medicine |
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Online Access: | https://www.mdpi.com/2077-0383/9/9/2983 |
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author | Daniel MF Claassens Dirk Sibbing |
author_facet | Daniel MF Claassens Dirk Sibbing |
author_sort | Daniel MF Claassens |
collection | DOAJ |
description | In acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), treatment with the P2Y<sub>12</sub> inhibitors ticagrelor or prasugrel is recommended over clopidogrel due to a better efficacy, albeit having more bleeding complication. These higher bleeding rates have provoked trials investigating de-escalation from ticagrelor or prasugrel to clopidogrel in the hope of reducing bleeding without increasing thrombotic event rates. In this review, we sought to present an overview of the major trials investigating several different options for de-escalation; unguided, platelet function testing- and genotype-guided. Based on these results, and on other established literature sources, such as guidelines and expert consensus papers, we provide an overview to help decide when and how to de-escalate antiplatelet therapy in ACS patients undergoing PCI. |
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format | Article |
id | doaj.art-3c2646d6024e4808a028ab8b1026d794 |
institution | Directory Open Access Journal |
issn | 2077-0383 |
language | English |
last_indexed | 2024-03-10T16:18:25Z |
publishDate | 2020-09-01 |
publisher | MDPI AG |
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series | Journal of Clinical Medicine |
spelling | doaj.art-3c2646d6024e4808a028ab8b1026d7942023-11-20T13:51:01ZengMDPI AGJournal of Clinical Medicine2077-03832020-09-0199298310.3390/jcm9092983De-Escalation of Antiplatelet Treatment in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Review of the Current LiteratureDaniel MF Claassens0Dirk Sibbing1Department of Cardiology, St. Antonius Hospital, 3435CM Nieuwegein, The NetherlandsPrivatklinik Lauterbacher Mühle am Ostersee, 82402 Iffeldorf, GermanyIn acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), treatment with the P2Y<sub>12</sub> inhibitors ticagrelor or prasugrel is recommended over clopidogrel due to a better efficacy, albeit having more bleeding complication. These higher bleeding rates have provoked trials investigating de-escalation from ticagrelor or prasugrel to clopidogrel in the hope of reducing bleeding without increasing thrombotic event rates. In this review, we sought to present an overview of the major trials investigating several different options for de-escalation; unguided, platelet function testing- and genotype-guided. Based on these results, and on other established literature sources, such as guidelines and expert consensus papers, we provide an overview to help decide when and how to de-escalate antiplatelet therapy in ACS patients undergoing PCI.https://www.mdpi.com/2077-0383/9/9/2983P2Y<sub>12</sub> inhibitorclopidogrelticagrelorprasugrelde-escalationplatelet function testing |
spellingShingle | Daniel MF Claassens Dirk Sibbing De-Escalation of Antiplatelet Treatment in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Review of the Current Literature Journal of Clinical Medicine P2Y<sub>12</sub> inhibitor clopidogrel ticagrelor prasugrel de-escalation platelet function testing |
title | De-Escalation of Antiplatelet Treatment in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Review of the Current Literature |
title_full | De-Escalation of Antiplatelet Treatment in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Review of the Current Literature |
title_fullStr | De-Escalation of Antiplatelet Treatment in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Review of the Current Literature |
title_full_unstemmed | De-Escalation of Antiplatelet Treatment in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Review of the Current Literature |
title_short | De-Escalation of Antiplatelet Treatment in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Review of the Current Literature |
title_sort | de escalation of antiplatelet treatment in patients with myocardial infarction who underwent percutaneous coronary intervention a review of the current literature |
topic | P2Y<sub>12</sub> inhibitor clopidogrel ticagrelor prasugrel de-escalation platelet function testing |
url | https://www.mdpi.com/2077-0383/9/9/2983 |
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