Daniel Aradi*, Dome Dezsi, Gabor Veress and Bela Merkely Pages 446 - 450 ( 5 )
Platelet activation plays a central role in triggering and complicating acute coronary syndromes, especially in case of stent thrombosis and myocardial infarction. On top of aspirin, P2Y12- inhibitors are successfully used to treat and prevent these events for a duration of one year after an acute coronary episode or 6 months after drug-eluting stent implantation. However, patients with acute coronary syndromes remain at heightened risk for recurrent ischemic events after the recommended durations of P2Y12-inhibitors and therefore, prolonging treatment is often considered in clinical practice. However, the higher risk for bleeding limits the utility of such approach to a restricted group who is still poorly defined by available measures. This review aims to discuss potential benefits and highlight important pitfalls of prolonged treatment with P2Y12-inhibitors, with a focus on ticagrelor, an attractive reversible P2Y12-inhibitor in patients after myocardial infarction.
Bleeding, clopidogrel, late outcomes, PCI, prasugrel, thrombosis, ticagrelor.
Heart Center Balatonfured, Balatonfured, Heart Center Balatonfured, Balatonfured, Heart Center Balatonfured, Balatonfured, Heart and Vascular Center, Semmelweis University, Budapest