ANTI-THROMBOCYTIC DRUGS FOR ACUTE CORONARY SYNDROME: DIRECT COMPARISON OF HEMORRHAGIC SAFETY THROMBOCYTE P2Y12-RECEPTOR BLOCKERS TICAGRELOR AND CLOPIDROGEL (BASED ON PLATO STUDY RESULTS
https://doi.org/10.21518/2079-701X-2016-10-98-102
Abstract
Double anti-platelet therapy (DAPT) comprising a combination of acetylsalicylic acid and one of the thrombocyte P2Y12-receptor blockers is considered an obligatory element of the acute coronary syndrome (ACS) therapy [1–5]. Enlargement of the antiplatelet drugs range with active implementation of ticagrelor and prasugrel led to questions in cardiologists who render medical aid to acute coronary syndrome patients. Despite the priority use of these drugs declared in recommendations instead of clopidrogel doctors practically daily face a necessity to choose the optimal P2Y12 blocking agent assessing the expected individual effectiveness, hemorrhagic safety and cost of the rather long-acting therapy. For doctors practicing in the territory of the RF as opposed to doctors in other countries the problem of the P2Y12 blocking agent is less large-scale as they have to choose only between ticagrelor and clopidrogel (prasugrel is not applied in the RF).
About the Author
O. V. AVERKOV
Filatov Municipal Clinical Hospital No.15
Russian Federation
Russian Federation
MD
Moscow
References
1. Amsterdam EA, Wenger NK, Brindis RG, Casey DE Jr et al. American College of Cardiology; American Heart Association Task Force on Practice Guidelines; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons; American Association for Clinical Chemistry. 2014 AHA/ACC Guideline for the Management of Patients with Non-STElevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2014, 64: e139-e228.
2. O’Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines. Circulation, 2013, 127: e362-425.
3. Steg G, James DK, Atar D et al. Acute Myocardial Infarction in patients presenting with ST-segment elevation (Management of). European Heart Journal, 2012, 33: 2569-2619.
4. Roffi M, Patrono C, Collet JP, Mueller C et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J, 2016, 37: 267-315.
5. Руда М.Я., Аверков О.В., Голицын С.П. и соавт. Диагностика и лечение больных с острым инфарктом миокарда с подъемом сегмента ST электрокардиограммы. Кардиологический вестник, 2014, IX(4): 3-60. / Ruda M.Y., Averkov O.V., Golitsin S.P. et al. Diagnostics and therapy of acute myocardium infarction payments with ST-segment elevation on electrocardiogram. Kardiologichesky Vestnik, 2014, IX (4): 3-60.
6. Wallentin L, Becker RC, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med, 2009, 361. DOI: 10.1056/NEJMoa0904327.
7. Eikelboom JW, Mehta SR, Anand SS, Xie C, Fox KA, Yusuf S. Adverse impact of bleeding on prognosis in patients with acute coronary syndromes. Circulation, 2006, 114: 774-782.
8. Budaj A, Eikelboom JW, Mehta SR et al. Improving clinical outcomes by reducing bleeding in patients with non-ST-elevation acute coronary syndromes. Eur Heart J, 2009, 30: 655-661.
9. Mehran R, Pocock SJ, Stone GW et al. Associations of major bleeding and myocardial infarction with the incidence and timing of mortality in patients presenting with non- Televation acute coronary syndromes: a risk model from the ACUITY trial. Eur Heart J, 2009, 30: 1457-1466.
10. Becker RC, Bassand JP, Budaj A, Wojdyla DM et al. Bleeding complications with the P2Y12 receptor antagonists clopidogrel and ticagrelor in the PLATelet inhibition and patient Outcomes (PLATO) trial. Eur Heart J, 2011, 32: 2933-2944. doi:10.1093/eurheartj/ehr422.
11. DiNicolantonio JJ, D’Ascenzo F, Tomek A, Chatterjee S, Niazi AK, Biondi-Zoccai G Clopidogrel is safer than ticagrelor in regard to bleeds: a closer look at the PLATO trial. Int J Cardiol, 2013, 168(3): 1739-44. doi: 10.1016/j. ijcard.2013.06.135.
12. de Lemos JA, Brilakis ES. No free lunches: balancing bleeding and efficacy with ticagrelor. Eur Heart J, 2011, 32: 2919-2921.
13. Yusuf S, Zhao F, Mehta SR, Chrolavicius S Tognoni G, Fox KK. Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med, 2001, 345: 494-502.
14. FDA ticagrelor review of complete response – drug approval package. http://www.accessdata. fda.gov/drugsatfda_docs/nda/2011/022433Orig1s000TOC. cfm. In: Administration UFaD, editor. Silver Spring, MD: US Department of Health and Human Services, 2011.
15. Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S et al. TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med, 2007, 357: 2001-2015.
Review
For citations:
AVERKOV OV. ANTI-THROMBOCYTIC DRUGS FOR ACUTE CORONARY SYNDROME: DIRECT COMPARISON OF HEMORRHAGIC SAFETY THROMBOCYTE P2Y12-RECEPTOR BLOCKERS TICAGRELOR AND CLOPIDROGEL (BASED ON PLATO STUDY RESULTS. Meditsinskiy sovet = Medical Council. 2016;(10):98-102. (In Russ.) https://doi.org/10.21518/2079-701X-2016-10-98-102
Views:
3485
Email this article 