P2Y12-inhibitor monotherapy after coronary stenting
| Autor: | Niels MR van der Sangen, I Tarik Küçük, Jurriën M ten Berg, Marcel AM Beijk, Ronak Delewi, Alexander W den Hartog, Yolande Appelman, Niels JW Verouden, Wouter J Kikkert, José PS Henriques, Bimmer EPM Claessen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
clopidogrel
P2Y(12)-inhibitor monotherapy percutaneous coronary intervention General Medicine prasugrel ticagrelor ASPIRIN DRUG-ELUTING STENTS PLATELET REACTIVITY Dual antiplatelet therapy Internal Medicine ARTERY-DISEASE Cardiology and Cardiovascular Medicine CARDIOVASCULAR EVENTS P2Y-inhibitor monotherapy INTERVENTION |
| Zdroj: | van der Sangen, N M R, Küçük, I T, ten Berg, J M, Beijk, M A M, Delewi, R, den Hartog, A W, Appelman, Y, Verouden, N J W, Kikkert, W J, Henriques, J P S & Claessen, B E PM 2022, ' P2Y12-inhibitor monotherapy after coronary stenting : are all P2Y12-inhibitors equal? ', Expert Review of Cardiovascular Therapy, vol. 20, no. 8, pp. 637-645 . https://doi.org/10.1080/14779072.2022.2104248 |
| ISSN: | 1477-9072 |
| Popis: | Introduction: P2Y(12)-inhibitor monotherapy following 1-3 months of dual antiplatelet therapy (DAPT) reduces (major) bleeding without an apparent increase in ischemic events and has therefore emerged as an alternative to 6-12 months of DAPT following percutaneous coronary intervention (PCI). However, there are important differences between the available P2Y(12)-inhibitors (clopidogrel, prasugrel, and ticagrelor) as agents of choice for P2Y(12)-inhibitor monotherapy.Areas covered: This review critically appraises the evidence for P2Y(12)-inhibitor monotherapy after PCI using either clopidogrel, prasugrel, or ticagrelor. Furthermore, we discuss ongoing trials and future directions for research.Expert opinion: P2Y(12)-inhibitor monotherapy following 1-3 months of DAPT is an alternative to 6-12 months of DAPT following PCI. Ticagrelor may be considered the current preferred option due to its reliable effect on platelet reactivity and its predominant use in clinical trials. Prasugrel could serve as a useful substitute for those not tolerating ticagrelor, but more research into prasugrel monotherapy is warranted. Alternatively, clopidogrel can be used, although there are concerns of high platelet reactivity, especially when genotyping and/or platelet function testing are not used. Future research will need to address the minimal duration of DAPT before switching to P2Y(12)-inhibitor monotherapy and what the optimal antithrombotic therapy beyond 12 months is. |
| Databáze: | OpenAIRE |
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