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October 13, 2025Expert Opinion on Pharmacotherapy

Optimizing selection of P2Y 12 inhibiting therapy: clopidogrel, prasugrel or ticagrelor

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Why the study?

Given differing pharmacodynamic, pharmacogenomic, and safety-efficacy profiles among clopidogrel, prasugrel, and ticagrelor, the optimal selection of oral P2Y12 inhibitors remains an active area of investigation.

Comparison

Clopidogrel, prasugrel, and ticagrelor with or without aspirin

Design

Review

Key result

The selection of oral P2Y12 inhibitors should be individualized based on clinical, demographic, and genetic factors to balance ischemic and bleeding risks.

Authors

MGMattía GalliBSBeatrice SimeoneFGFelice Gragnano

Discussion

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Overview

Supports individualized P2Y12 selection in ASCVD practice; extends prior syntheses by emphasizing dynamic risk reassessment.

Study Design

Type

Systematic Review

Structured PICO

P
Population
Patients with atherosclerotic cardiovascular disease, particularly those undergoing percutaneous coronary intervention (PCI)
I
Intervention
Oral P2Y12 inhibitors (clopidogrel, prasugrel, ticagrelor) with or without aspirin

Selection of oral P2Y12 inhibitors in ASCVD patients should be individualized based on clinical, demographic, and genetic factors, balancing ischemic and bleeding risks.

Cite This Study

Galli et al. (2025) conducted a systematic review in Atherosclerotic cardiovascular disease. Oral P2Y12 inhibitors (clopidogrel, prasugrel, ticagrelor) was evaluated. The selection of oral P2Y12 inhibitors should be individualized based on clinical, demographic, and genetic factors to balance ischemic and bleeding risks.

synapsesocial.com/papers/6a7db128c2b228f3e18c9a4fhttps://doi.org/10.1080/14656566.2025.2576607
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Genetic testing in patients undergoing percutaneous coronary intervention: rationale, evidence and practical recommendations2021 · 50 citations
  2. 2Pharmacodynamic Comparison of Prasugrel Versus Ticagrelor in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease2016 · 96 citations
  3. 3Basic Principles of Platelet Biology and Clinical Implications2010 · 277 citations
  4. 4Prasugrel versus Clopidogrel in Patients with Acute Coronary Syndromes2007 · 6,815 citations
  5. 5Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS2020 · 184 citations