The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Editorial

De-escalation of oral P2Y12 inhibitors guided by platelet function testing in ACS patients undergoing PCI: impact of diabetes mellitus

EuroIntervention 2019;15:e486-e489. DOI: 10.4244/EIJV15I6A89

1. Division of Cardiology, CAST Policlinico Hospital, University of Catania, Catania, Italy; 2. Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA


In patients with an acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), one-year dual antiplatelet therapy (DAPT) with low-dose aspirin plus a platelet P2Y12 receptor antagonist is the mainstay strategy for the prevention of recurrent atherothrombotic complications1. Among the P2Y12 inhibitors, prasugrel and ticagrelor are preferred over clopidogrel1. However, the observation that the greatest anti-ischaemic benefits of more potent P2Y12 inhibitors are seen early after an acute coronary event, while bleeding complications continue to accrue over time during long-term treatment with these drugs, has set the rationale for studies of switching (i.e., de-escalating) the ...

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