Abstract
Platelet activation plays a central role in triggering and complicating acute coronary syndromes, especially in case of stent thrombosis and myocardial infarction. On top of aspirin, P2Y12- inhibitors are successfully used to treat and prevent these events for a duration of one year after an acute coronary episode or 6 months after drug-eluting stent implantation. However, patients with acute coronary syndromes remain at heightened risk for recurrent ischemic events after the recommended durations of P2Y12-inhibitors and therefore, prolonging treatment is often considered in clinical practice. However, the higher risk for bleeding limits the utility of such approach to a restricted group who is still poorly defined by available measures. This review aims to discuss potential benefits and highlight important pitfalls of prolonged treatment with P2Y12-inhibitors, with a focus on ticagrelor, an attractive reversible P2Y12-inhibitor in patients after myocardial infarction.
Keywords: Bleeding, clopidogrel, late outcomes, PCI, prasugrel, thrombosis, ticagrelor.
Current Vascular Pharmacology
Title:Prolonging Ticagrelor Beyond a Year of Acute Coronary Syndrome: Worth or Harmful?
Volume: 16 Issue: 5
Author(s): Daniel Aradi*, Dome Dezsi, Gabor Veress and Bela Merkely
Affiliation:
- Heart Center Balatonfured, Balatonfured,Hungary
Keywords: Bleeding, clopidogrel, late outcomes, PCI, prasugrel, thrombosis, ticagrelor.
Abstract: Platelet activation plays a central role in triggering and complicating acute coronary syndromes, especially in case of stent thrombosis and myocardial infarction. On top of aspirin, P2Y12- inhibitors are successfully used to treat and prevent these events for a duration of one year after an acute coronary episode or 6 months after drug-eluting stent implantation. However, patients with acute coronary syndromes remain at heightened risk for recurrent ischemic events after the recommended durations of P2Y12-inhibitors and therefore, prolonging treatment is often considered in clinical practice. However, the higher risk for bleeding limits the utility of such approach to a restricted group who is still poorly defined by available measures. This review aims to discuss potential benefits and highlight important pitfalls of prolonged treatment with P2Y12-inhibitors, with a focus on ticagrelor, an attractive reversible P2Y12-inhibitor in patients after myocardial infarction.
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Cite this article as:
Aradi Daniel*, Dezsi Dome, Veress Gabor and Merkely Bela, Prolonging Ticagrelor Beyond a Year of Acute Coronary Syndrome: Worth or Harmful?, Current Vascular Pharmacology 2018; 16 (5) . https://dx.doi.org/10.2174/1570161116666180117104613
DOI https://dx.doi.org/10.2174/1570161116666180117104613 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
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