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Prolonging Ticagrelor Beyond a Year of Acute Coronary Syndrome: Worth or Harmful?

[ Vol. 16 , Issue. 5 ]

Author(s):

Daniel Aradi*, Dome Dezsi, Gabor Veress and Bela Merkely   Pages 446 - 450 ( 5 )

Abstract:


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.

Keywords:

Bleeding, clopidogrel, late outcomes, PCI, prasugrel, thrombosis, ticagrelor.

Affiliation:

Heart Center Balatonfured, Balatonfured, Heart Center Balatonfured, Balatonfured, Heart Center Balatonfured, Balatonfured, Heart and Vascular Center, Semmelweis University, Budapest

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