Current options in oral antiplatelet strategies during percutaneous coronary interventions

Udaya S. Tantry, Paul A. Gurbel

Research output: Contribution to journalReview article

Abstract

Dual antiplatelet therapy (DAPT) with aspirin and a P2Y 12 receptor blocker is the standard of care to prevent recurrent ischemic event occurrence in patients undergoing percutaneous intervention. Glycoprotein IIb/IIIa receptor inhibitors are used in addition to DAPT in the highest-risk clinical settings. The persistent occurrence of ischemic events in the presence of DAPT and the irrefutable demonstration of clopidogrel response variability are two potent arguments against the widely practiced nonselective or "one-size-fits-all" strategy of administering clopidogrel therapy and provides a strong rationale for monitoring clopidogrel therapy. New, potent P2Y 12 inhibitors such as prasugrel and ticagrelor are associated with greater platelet inhibition, faster onset of action, and better overall clinical outcomes compared with clopidogrel, but are associated with more non-surgery-related bleeding than clopidogrel. The inhibition of the platelet thrombin receptor may provide additional benefits in attenuating ischemic event occurrence in selected high-risk patients treated with DAPT.

Original languageEnglish (US)
Pages (from-to)S4-S13
JournalReviews in Cardiovascular Medicine
Volume12
Issue numberSUPPL. 1
DOIs
StatePublished - Dec 1 2011

Keywords

  • Antiplatelet agents
  • Aspirin
  • GP IIb/IIIa inhibitors
  • Par inhibitors
  • Percutaneous coronary intervention
  • Thienopyridines
  • Ticagrelor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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