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International Expert Consensus on Switching Platelet P2Y(12) Receptor-Inhibiting Therapies
Univ Florida, Coll Med, Div Cardiol, Jacksonville, FL USA..
Univ Florida, Coll Med, Div Cardiol, Jacksonville, FL USA..
Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England..
Brigham & Womens Hosp, Harvard Med Sch, Heart & Vasc Ctr, Boston, MA USA..
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2017 (English)In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 136, no 20, p. 1955-+Article in journal (Refereed) Published
Abstract [en]

Dual antiplatelet therapy with aspirin and a P2Y(12) inhibitor is the treatment of choice for the prevention of atherothrombotic events in patients with acute coronary syndromes and for those undergoing percutaneous coronary interventions. The availability of different oral P2Y(12) inhibitors (clopidogrel, prasugrel, ticagrelor) has enabled physicians to contemplate switching among therapies because of specific clinical scenarios. The recent introduction of an intravenous P2Y(12) inhibitor (cangrelor) further adds to the multitude of modalities and settings in which switching therapies may occur. In clinical practice, it is not uncommon to switch P2Y(12) inhibitor, and switching may be attributed to a variety of factors. However, concerns about the safety of switching between these agents have emerged. Practice guidelines have not fully elaborated on how to switch therapies, leaving clinicians with limited guidance on when and how to switch therapies when needed. This prompted the development of this expert consensus document by key leaders from North America and Europe with expertise in basic, translational, and clinical sciences in the field of antiplatelet therapy. This expert consensus provides an overview of the pharmacology of P2Y(12) inhibitors, different modalities and definitions of switching, and available literature and recommendations for switching between P2Y(12) inhibitors.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2017. Vol. 136, no 20, p. 1955-+
Keywords [en]
drug interactions, hemorrhage, pharmacodynamics, platelet aggregation inhibitors, P2Y(12) receptor inhibitors, thrombosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-356359DOI: 10.1161/CIRCULATIONAHA.117.031164ISI: 000415712100010PubMedID: 29084738OAI: oai:DiVA.org:uu-356359DiVA, id: diva2:1235276
Funder
AstraZenecaNIH (National Institute of Health), UL1 TR000064NIH (National Institute of Health), U01 HG007269Available from: 2018-07-25 Created: 2018-07-25 Last updated: 2018-07-25Bibliographically approved

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