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        Platelet inhibition in acute coronary syndrome and PCI: Insights from the past and present

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        Platelet_inhibition_in_ACS_and_PCI_Insights_from_the_past_and_present_02.01.20.pdf (PDF, 907Kb)
        Author
        Gorog, Diana
        Geisler, Tobias
        Attention
        2299/22413
        Abstract
        Platelet activation and aggregation have a pivotal role in arterial thrombosis and in the pathogenesis of both acute coronary syndromes (ACS) and in the thrombotic complications that occur in patients undergoing percutaneous coronary intervention (PCI). The last 30 years has seen the progress from early trials of clopidogrel and glycoprotein IIb/IIIa inhibitors, to the application of more potent P2Y12 inhibitors prasugrel and ticagrelor. Early enthusiasm for newer and more potent antiplatelet agents, which could reduce ischaemic events, has led to the understanding of the importance of bleeding and a desire to individualise and optimise treatment. It has increasingly become apparent that the potency and duration of dual antiplatelet therapy (DAPT) has to reflect the balance between ischaemic and bleeding risk. Recently, multiple strategies have been proposed to individualise DAPT intensity and duration, in order to reduce the bleeding and ischaemic risks. Strategies of de-escalation of DAPT intensity, as well as shorter (less than a year) or more prolonged (beyond a year) treatment have been proposed, as well as platelet function test and genotype guidance of P2Y12 inhibitor therapy. Herein, we provide an overview of the progress in the field of antiplatelet therapy for ACS and PCI over the years, showing the current directions of travel. Ongoing studies focusing on personalised antiplatelet treatment will hopefully yield further insight into ways of optimising outcomes for the individual.
        Publication date
        2020-01-19
        Published in
        Thrombosis and haemostasis
        Published version
        https://doi.org/10.1055/s-0040-1702920
        Other links
        http://hdl.handle.net/2299/22413
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