The Timing of P2Y12 Inhibitor Initiation in the Treatment of ACS? Does the Evidence Exist in This Era?

The majority of acute coronary syndromes (ACS) are well characterized as a consequence of plaque rupture and subsequent thrombosis. Antiplatelet agents targeting inhibition of P2Y12 receptors on the platelets have been shown to reduce future risk of cardiovascular events in this patient population. However, the timing of initiation of these agents, in particular, in patients managed with an invasive strategy with percutaneous coronary interventions (PCI) is debatable. The data supporting pretreatment with antiplatelet agents prior to PCI in ACS patients date to trials performed>15  years ago, wherein the time to PCI was>5  days, and hence, the utility of pretreatment with these agents in the contemporary era remains uncertain.

Source: Progress in Cardiovascular Diseases - January 12, 2018 Category: Cardiology Authors: Harsh Golwala, Deepak L. Bhatt Source Type: research