Why the study?
Does pre-treatment with a P2Y12 antagonist before angiography improve outcomes compared to starting therapy after angiography in patients with non-ST elevation acute coronary syndromes?
Does pre-treatment with a P2Y12 antagonist before angiography improve outcomes compared to starting therapy after angiography in patients with non-ST elevation acute coronary syndromes?
This review highlights that pre-treatment with prasugrel before angiography in NSTE-ACS does not offer clinical benefit over administration just prior to PCI, challenging previous guideline recommendations.
No support for prasugrel pre-treatment in NSTE-ACS; leaves open randomized confirmation of optimal timing.
The optimal time-point of the initiation of P2Y12 antagonist therapy in patients with non-ST elevation acute coronary syndromes (NTSE-ACS) is still a matter of debate. European guidelines recommend P2Y12 as soon as possible after first medical contact. However, the only trial which compared the two strategies did not demonstrate any benefit of pre-treatment with prasugrel before angiography compared to starting therapy after angiography and just prior to percutaneous coronary intervention (PCI). This paper summarizes the results of pharmacodynamic and previous studies, and gives recommendations for the initiation of P2Y12 antagonist therapy in NSTE-ACS in different clinical situations.
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Zeymer et al. (2015) conducted a review in non-ST elevation acute coronary syndromes (NSTE-ACS). Pre-treatment with prasugrel before angiography vs. Starting therapy after angiography and just prior to PCI was evaluated.
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