Abstract
Background: Patients with ST-segment elevation myocardial infarction represent a high-risk population and an effective antiplatelet treatment adjunctive to primary percutaneous coronary intervention is of paramount importance.
Methods: This topic will review the current evidence on clinical efficacy and safety of oral antiplatelet therapy in patients with an acute ST-segment elevation myocardial infarction. Unsettled issues and future perspectives for their use in these patients are also discussed.
Results: Added to aspirin, clopidogrel, prasugrel and ticagrelor represent viable options regarding oral P2Y12 inhibition, with prasugrel and ticagrelor being preferred over clopidogrel, according to results of large randomized clinical trials. Early clinical efficacy of oral antiplatelet agents in STEMI patients has been questioned, mainly because of their delayed onset of action in the clinical setting of ST-segment elevation myocardial infarction and the recently described adverse effect of morphine on their pharmacodynamic/pharmacokinetic profile. Whether these agents should be administered beyond 1 year after the index event is also under discussion, as there is clinical evidence that prolonged administration may be associated with clinical benefit.
Conclusion: Use of oral P2Y12 inhibitors in patients with ST-segment elevation myocardial infarction still faces questions and future research is needed to establish which, when and how should be administered in this clinical setting.
Keywords: ST elevation myocardial infarction, percutaneous coronary intervention, clopidogrel, prasugrel, ticagrelor.
Current Pharmaceutical Design
Title:Oral Antiplatelet Treatment in STEMI: Current Practice and Future Considerations
Volume: 22 Issue: 29
Author(s): Ioanna Xanthopoulou and Dimitrios Alexopoulos
Affiliation:
Keywords: ST elevation myocardial infarction, percutaneous coronary intervention, clopidogrel, prasugrel, ticagrelor.
Abstract: Background: Patients with ST-segment elevation myocardial infarction represent a high-risk population and an effective antiplatelet treatment adjunctive to primary percutaneous coronary intervention is of paramount importance.
Methods: This topic will review the current evidence on clinical efficacy and safety of oral antiplatelet therapy in patients with an acute ST-segment elevation myocardial infarction. Unsettled issues and future perspectives for their use in these patients are also discussed.
Results: Added to aspirin, clopidogrel, prasugrel and ticagrelor represent viable options regarding oral P2Y12 inhibition, with prasugrel and ticagrelor being preferred over clopidogrel, according to results of large randomized clinical trials. Early clinical efficacy of oral antiplatelet agents in STEMI patients has been questioned, mainly because of their delayed onset of action in the clinical setting of ST-segment elevation myocardial infarction and the recently described adverse effect of morphine on their pharmacodynamic/pharmacokinetic profile. Whether these agents should be administered beyond 1 year after the index event is also under discussion, as there is clinical evidence that prolonged administration may be associated with clinical benefit.
Conclusion: Use of oral P2Y12 inhibitors in patients with ST-segment elevation myocardial infarction still faces questions and future research is needed to establish which, when and how should be administered in this clinical setting.
Export Options
About this article
Cite this article as:
Xanthopoulou Ioanna and Alexopoulos Dimitrios, Oral Antiplatelet Treatment in STEMI: Current Practice and Future Considerations, Current Pharmaceutical Design 2016; 22 (29) . https://dx.doi.org/10.2174/1381612822666160601111155
DOI https://dx.doi.org/10.2174/1381612822666160601111155 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Triad: Erectile Dysfunction - Endothelial Dysfunction - Cardiovascular Disease
Current Pharmaceutical Design Evidence of Lifestyle Modification in the Management of Hypercholesterolemia
Current Cardiology Reviews Silent Partner in Blood Vessel Homeostasis? Pervasive Role of Nitric Oxide in Vascular Disease
Current Hypertension Reviews Cardiovascular Disease Risk and Hormone Replacement Therapy (HRT): A Review Based on Randomised, Controlled Studies in Postmenopausal Women
Current Medicinal Chemistry The IL23/Th17 Pathway as a Therapeutic Target in Chronic Inflammatory Diseases
Inflammation & Allergy - Drug Targets (Discontinued) GRK2 at the Control Shaft of Cellular Metabolism
Current Pharmaceutical Design Blood Atherogenicity as a Target for Anti-atherosclerotic Therapy
Current Pharmaceutical Design The Role of Mass Spectrometry in the “Omics” Era
Current Organic Chemistry Evolutionary Advantage and Molecular Modes of Action of Multi-Component Mixtures Used in Phytomedicine
Current Drug Metabolism Applications of Circadian Metabolomics
Current Metabolomics Role of Sulfur Containing Amino Acids as an Adjuvant Therapy in the Prevention of Diabetes and its Associated Complications
Current Diabetes Reviews Advances in the Chemistry of Saccharins: From Synthetic Novelties Towards Biologically Active Compounds
Current Medicinal Chemistry Endotoxin, Toll-like Receptor-4, and Atherosclerotic Heart Disease
Current Cardiology Reviews Piperine: Medicinal, Analytical and Therapeutics perspective
Current Bioactive Compounds Immune-Neuroendocrine Interactions Involving Thymus and Pineal Gland in Stem Cell Therapy of Age-Related Diseases
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Women Tipping the Scale During Pregnancy: A Special Population for Obesity Interventions,Treatments and Clinical Trials
Current Pharmaceutical Design Psychoemotional Background of Temporomandibular Joint Dysfunction and Possible Drug Therapy
Letters in Drug Design & Discovery Heme Oxygenase-1: A Potential Antihypertensive Target?
Current Hypertension Reviews Neopterin: From Forgotten Biomarker to Leading Actor in Cardiovascular Pathophysiology
Current Vascular Pharmacology The Impact of Docosahexaenoic Acid on Alzheimer’s Disease: Is There a Role of the Blood-Brain Barrier?
Current Clinical Pharmacology