Key result
Routine P2Y12 inhibitor pre-treatment fails to reduce ischemic events before angiography in ACS while increasing bleeding risk.
Why the study?
The choice of agent, timing of initiation, and duration of dual antiplatelet therapy in patients with acute coronary syndrome remain actively discussed clinical issues.
May warrant avoiding routine P2Y12 pre-treatment in ACS; leaves open optimal timing from randomized trials.
In recent years, the issues of choice of an agent for dual antiplatelet therapy (DAPT) as well as timing of initiation and duration of DAPT in patients with acute coronary syndrome (ACS) have been actively discussed. In this article we present data of major randomized trials of clopidogrel and novel P2Y12 inhibitors - prasugrel, ticagrelor, cangrelor - assessing strategy of administration of antiaggregants in patients with ACS before coronary angiography / percutaneous coronary intervention. The article also contains analysis of differences between recommendations of the European Society of Cardiology and American College of Cardiology/American Heart Association on therapy with oral P2Y12 inhibitors in the management of patients with ACS.
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Шалаев et al. (2018) conducted a review in Acute Coronary Syndrome. P2Y12 inhibitors was evaluated. Routine pre-treatment with P2Y12 inhibitors before coronary angiography in patients with acute coronary syndrome lacks sufficient evidence, as early administration may increase bleeding risk without significantly reducing ischemic events.
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