Clopidogrel: still king of the ring for elective percutaneous coronary intervention!

Clopidogrel is the P2Y12 inhibitor of choice for elective percutaneous coronary intervention (PCI) and is recommended in the current guidelines for the management of chronic coronary syndrome (CCS)1. Post-PCI elevation of cardiac biomarkers related to cardiac myonecrosis remains, however, a common complication particularly with the wider use of high-sensitivity cardiac troponin2. Such complications affect patients’ prognoses, including all-cause mortality and major cardiovascular events, notably in cases of major periprocedural myocardial infarction (MI) or type 4a MI3. Consequently, strategies have been considered to prevent these complications, including the off-label use of more potent P2Y12 inhibitors. Prasugrel and ticagrelor ...