International Expert Consensus on Switching Platelet P2Y12 Receptor-Inhibiting Therapies

被引：295

作者：

Angiolillo, Dominick J. ^{[1
]}

Rollini, Fabiana ^{[1
]}

Storey, Robert F. ^{[2
]}

Bhatt, Deepak L. ^{[3
]}

James, Stefan ^{[4
]}

Schneider, David J. ^{[5
]}

Sibbing, Dirk ^{[6
,7
]}

So, Derek Y. F. ^{[8
]}

Trenk, Dietmar ^{[9
]}

Alexopoulos, Dimitrios ^{[10
]}

Gurbel, Paul A. ^{[11
]}

Hochholzer, Willibald ^{[9
]}

De Luca, Leonardo ^{[12
,14
,15
]}

Bonello, Laurent ^{[13
]}

Aradi, Daniel ^{[16
,17
]}

Cuisset, Thomas ^{[18
,19
]}

Tantry, Udaya S. ^{[11
]}

Wang, Tracy Y. ^{[20
]}

Valgimigli, Marco ^{[21
]}

Waksman, Ron ^{[22
]}

Mehran, Roxana ^{[23
]}

Montalescot, Gilles ^{[24
]}

Franchi, Francesco ^{[1
]}

Price, Matthew J. ^{[25
]}

机构：

[1] Univ Florida, Coll Med, Div Cardiol, Jacksonville, FL USA

[2] Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England

[3] Brigham & Womens Hosp, Harvard Med Sch, Heart & Vasc Ctr, Boston, MA USA

[4] Uppsala Univ Sweden, Dept Med Sci, Cardiol & Uppsala Clin Res Ctr, Uppsala, Sweden

[5] Univ Vermont, Cardiovasc Res Inst, Cardiol Unit, Dept Med, Burlington, VT 05405 USA

[6] Ludwig Maximilians Univ Munchen, Dept Cardiol, Munich, Germany

[7] DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Berlin, Germany

[8] Univ Ottawa, Heart Inst, Div Cardiol, Ottawa, ON, Canada

[9] Univ Heart Ctr Freiburg Bad Krozingen, Dept Cardiol & Angiol 2, Freiberg, Germany

[10] Natl & Capodistrian Univ Athens, Dept Cardiol 2, Attikon Univ Hosp, Athens, Greece

[11] Inova Heart & Vasc Inst, Inova Ctr Thrombosis Res & Drug Dev, Falls Church, VA USA

[12] San Giovanni Evangelista Hosp, Lab Intervent Cardiol, Div Cardiol, Tivoli, Italy

[13] Hop Nord Marseille, AP HP, Dept Cardiol, Marseille, France

[14] Mediterranean Acad Assoc Res & Studies Cardiol, Marseille, France

[15] Aix Marseille Univ, INSERM, UMRS 1076, Marseille, France

[16] Heart Ctr Balatonfured, Budapest, Hungary

[17] Semmelweis Univ Budapest, Budapest, Hungary

[18] CHU Timone, Dept Cardiol, Marseille, France

[19] Aix Marseille Univ, Fac Med, Marseille, France

[20] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA

[21] Bern Univ Hosp, Swiss Cardiovasc Ctr Bern, Bern, Switzerland

[22] MedStar Washington Hosp Ctr, Sect Intervent Cardiol, Washington, DC USA

[23] Icahn Sch Med Mt Sinai, New York, NY USA

[24] Sorbonne Univ Paris 6, Hop Pitie Salpetriere, ACTION Study Grp, Paris, France

[25] Scripps Clin, Div Cardiovasc Dis, La Jolla, CA USA

来源：

CIRCULATION | 2017年 / 136卷 / 20期

基金：

美国国家卫生研究院;

关键词：

drug interactions; hemorrhage; pharmacodynamics; platelet aggregation inhibitors; P2Y(12) receptor inhibitors; thrombosis; ACUTE CORONARY SYNDROME; ELEVATION MYOCARDIAL-INFARCTION; ADJUST ANTIPLATELET THERAPY; HIGH-DOSE CLOPIDOGREL; PERCUTANEOUS CORONARY; ANTITHROMBOTIC THERAPY; INTERVENTION INSIGHTS; CONTEMPORARY PRACTICE; ACTIVE METABOLITES; RANDOMIZED-TRIAL;

D O I：

10.1161/CIRCULATIONAHA.117.031164

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Dual antiplatelet therapy with aspirin and a P2Y(12) 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(12) inhibitors (clopidogrel, prasugrel, ticagrelor) has enabled physicians to contemplate switching among therapies because of specific clinical scenarios. The recent introduction of an intravenous P2Y(12) 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(12) 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(12) inhibitors, different modalities and definitions of switching, and available literature and recommendations for switching between P2Y(12) inhibitors.

引用

页码：1955 / +

页数：59

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