International Expert Consensus on Switching Platelet P2Y<sub>12</sub> Receptor-Inhibiting Therapies.
Citation: Circulation. 136(20):1955-1975, 2017 Nov 14PMID: 29084738Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Consensus | *Drug Substitution/mt [Methods] | *Internationality | *Platelet Aggregation Inhibitors/ad [Administration & Dosage] | *Purinergic P2Y Receptor Antagonists/ad [Administration & Dosage] | Administration, Intravenous | Administration, Oral | Aspirin/ad [Administration & Dosage] | Humans | Ticlopidine/aa [Analogs & Derivatives] | Ticlopidine/ad [Administration & Dosage]Year: 2017Local holdings: Available online from MWHC library: 1950 - present, Available in print through MWHC library: 1999 - 2006ISSN:- 0009-7322
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 29084738 | Available | 29084738 |
Available online from MWHC library: 1950 - present, Available in print through MWHC library: 1999 - 2006
Dual antiplatelet therapy with aspirin and a P2Y<sub>12</sub> inhibitor is the treatment of choice for the prevention of atherothrombotic events in patients with acute coronary syndromes and for those undergoing percutaneous coronary interventions. The availability of different oral P2Y<sub>12</sub> inhibitors (clopidogrel, prasugrel, ticagrelor) has enabled physicians to contemplate switching among therapies because of specific clinical scenarios. The recent introduction of an intravenous P2Y<sub>12</sub> inhibitor (cangrelor) further adds to the multitude of modalities and settings in which switching therapies may occur. In clinical practice, it is not uncommon to switch P2Y<sub>12</sub> inhibitor, and switching may be attributed to a variety of factors. However, concerns about the safety of switching between these agents have emerged. Practice guidelines have not fully elaborated on how to switch therapies, leaving clinicians with limited guidance on when and how to switch therapies when needed. This prompted the development of this expert consensus document by key leaders from North America and Europe with expertise in basic, translational, and clinical sciences in the field of antiplatelet therapy. This expert consensus provides an overview of the pharmacology of P2Y<sub>12</sub> inhibitors, different modalities and definitions of switching, and available literature and recommendations for switching between P2Y<sub>12</sub> inhibitors.
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