liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Risks and Benefits of Triple Oral Anti-Thrombotic Therapies After Acute Coronary Syndromes and Percutaneous Coronary Intervention
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
Duke University of School Med, NC USA.
2015 (English)In: Drug Safety, ISSN 0114-5916, E-ISSN 1179-1942, Vol. 38, no 5, p. 481-491Article, review/survey (Refereed) Published
Abstract [en]

The key pathophysiological process underlying symptomatic coronary artery disease, including acute coronary syndromes (ACS), is usually a rupture or an erosion of an atherosclerotic plaque, followed by platelet activation and subsequent thrombus formation. Early clinical trials showed benefit with long-term aspirin treatment, and later-based on large clinical trials-dual anti-platelet therapy (DAPT), initially with clopidogrel, and more recently with prasugrel or ticagrelor, has become the established treatment in the post-ACS setting and after percutaneous coronary intervention (PCI). Treatment with DAPT is recommended for both ST-elevation myocardial infarction and non-ST-elevation ACS, as well as after PCI with stenting, in American and European clinical guidelines. Notwithstanding the benefits observed with DAPT, including third-generation P2Y(12) receptor inhibitors plus aspirin, ACS patients remain at high risk for a recurrent cardiovascular event, suggesting that other treatment strategies, including the addition of a third oral anti-platelet agent or a novel oral anticoagulant (NOAC) to standard DAPT regimens, may provide additional benefit for post-ACS patients and for patients undergoing PCI. Adding a third anti-thrombotic agent to DAPT after an ACS event or a PCI procedure has been shown to have modest benefit in terms of ischemic event reduction, but has consistently been associated with increased bleeding complications. Therefore, the quest to optimize anti-thrombotic therapies post-ACS and post-PCI continues unabated but is tempered by the historical experiences to date that indicate that careful patient and dose selection will be critical features of future randomized trials.

Place, publisher, year, edition, pages
Adis / Springer Verlag (Germany) , 2015. Vol. 38, no 5, p. 481-491
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-118035DOI: 10.1007/s40264-015-0286-8ISI: 000353516700005PubMedID: 25829216OAI: oai:DiVA.org:liu-118035DiVA, id: diva2:813084
Note

Funding Agencies|Astra-Zeneca; Novartis; Merck; Sharp Dome; Sanofi-Aventis; Eli Lilly; Amgen; DaiichiSanko; Janssen Pharmaceuticals; Ferring Pharmaceuticals; ACC; AHA; Familial Hypercholesterolemia Foundation

Available from: 2015-05-21 Created: 2015-05-20 Last updated: 2017-12-04

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records

Alfredsson, Joakim

Search in DiVA

By author/editor
Alfredsson, Joakim
By organisation
Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in Linköping
In the same journal
Drug Safety
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 348 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf