Key result
This review summarizes current recommendations and supporting evidence regarding pretreatment with oral and intravenous P2Y12 inhibitors in patients with acute coronary syndromes.
Why the study?
The practice of pretreatment with oral P2Y12 inhibitors in acute coronary syndromes has been controversial following recent trial publications and the introduction of intravenous cangrelor.
This review summarizes current recommendations and evidence regarding the controversial practice of pretreating acute coronary syndrome patients with oral or intravenous P2Y12 inhibitors before defining coronary anatomy.
Pretreatment with oral P2Y12 inhibitors occurs each time clopidogrel, prasugrel, ticagrelor are given to patients with suspected coronary artery disease before definition of the coronary anatomy. In acute coronary syndromes, the practice of administering oral P2Y12 inhibitors upstream has been the object of significant controversy in recent years, following the publication of two trials of pretreatment in non-ST-segment elevation acute coronary syndromes and ST-segment elevation myocardial infarction, respectively. The introduction in the market of cangrelor - the first intravenous P2Y12 inhibitor - represents a new opportunity but also a new challenge for clinicians. This article reviews current recommendations and supporting evidence surrounding pretreatment with oral and intravenous P2Y12 inhibitors in patients with acute coronary syndromes.
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Capodanno et al. (2016) conducted a review in acute coronary syndromes. Pretreatment with P2Y12 inhibitors was evaluated. This review summarizes current recommendations and supporting evidence regarding pretreatment with oral and intravenous P2Y12 inhibitors in patients with acute coronary syndromes.
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