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Implications of the Antiplatelet Therapy Gap Left With Discontinuation of Prasugrel in Canada
BACKGROUND: The current Canadian Cardiovascular Society antiplatelet therapy guidelines recommend the use of ticagrelor or prasugrel over clopidogrel as first-line platelet P2Y12 receptor antagonists for treatment of moderate- to high-risk acute coronary syndromes. Recently, Effient (prasugrel [Eli...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209390/ https://www.ncbi.nlm.nih.gov/pubmed/34169260 http://dx.doi.org/10.1016/j.cjco.2020.11.021 |
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author | Lordkipanidzé, Marie Marquis-Gravel, Guillaume Tanguay, Jean-François Mehta, Shamir R. So, Derek Y.F. |
author_facet | Lordkipanidzé, Marie Marquis-Gravel, Guillaume Tanguay, Jean-François Mehta, Shamir R. So, Derek Y.F. |
author_sort | Lordkipanidzé, Marie |
collection | PubMed |
description | BACKGROUND: The current Canadian Cardiovascular Society antiplatelet therapy guidelines recommend the use of ticagrelor or prasugrel over clopidogrel as first-line platelet P2Y12 receptor antagonists for treatment of moderate- to high-risk acute coronary syndromes. Recently, Effient (prasugrel [Eli Lilly Canada Inc, Toronto, Canada]) was discontinued by its distributor in Canada. METHODS: Five members of the Canadian Cardiovascular Society antiplatelet therapy 2018 guidelines committee undertook an independent, evidence-based review to outline patients for whom prasugrel should be the optimal P2Y12 agent and discuss alternative strategies to consider without prasugrel. RESULTS: Several clinical scenarios where prasugrel should be indicated are identified and discussed. Considerations to be undertaken for alternative therapies are summarized, including a review of national and international guidelines for de-escalation of P2Y12 receptor antagonists. CONCLUSIONS: The discontinuation of prasugrel poses a challenge for clinicians. Clinicians must consider key factors in determining the best alternate therapy. |
format | Online Article Text |
id | pubmed-8209390 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-82093902021-06-23 Implications of the Antiplatelet Therapy Gap Left With Discontinuation of Prasugrel in Canada Lordkipanidzé, Marie Marquis-Gravel, Guillaume Tanguay, Jean-François Mehta, Shamir R. So, Derek Y.F. CJC Open Original Article BACKGROUND: The current Canadian Cardiovascular Society antiplatelet therapy guidelines recommend the use of ticagrelor or prasugrel over clopidogrel as first-line platelet P2Y12 receptor antagonists for treatment of moderate- to high-risk acute coronary syndromes. Recently, Effient (prasugrel [Eli Lilly Canada Inc, Toronto, Canada]) was discontinued by its distributor in Canada. METHODS: Five members of the Canadian Cardiovascular Society antiplatelet therapy 2018 guidelines committee undertook an independent, evidence-based review to outline patients for whom prasugrel should be the optimal P2Y12 agent and discuss alternative strategies to consider without prasugrel. RESULTS: Several clinical scenarios where prasugrel should be indicated are identified and discussed. Considerations to be undertaken for alternative therapies are summarized, including a review of national and international guidelines for de-escalation of P2Y12 receptor antagonists. CONCLUSIONS: The discontinuation of prasugrel poses a challenge for clinicians. Clinicians must consider key factors in determining the best alternate therapy. Elsevier 2020-12-16 /pmc/articles/PMC8209390/ /pubmed/34169260 http://dx.doi.org/10.1016/j.cjco.2020.11.021 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Lordkipanidzé, Marie Marquis-Gravel, Guillaume Tanguay, Jean-François Mehta, Shamir R. So, Derek Y.F. Implications of the Antiplatelet Therapy Gap Left With Discontinuation of Prasugrel in Canada |
title | Implications of the Antiplatelet Therapy Gap Left With Discontinuation of Prasugrel in Canada |
title_full | Implications of the Antiplatelet Therapy Gap Left With Discontinuation of Prasugrel in Canada |
title_fullStr | Implications of the Antiplatelet Therapy Gap Left With Discontinuation of Prasugrel in Canada |
title_full_unstemmed | Implications of the Antiplatelet Therapy Gap Left With Discontinuation of Prasugrel in Canada |
title_short | Implications of the Antiplatelet Therapy Gap Left With Discontinuation of Prasugrel in Canada |
title_sort | implications of the antiplatelet therapy gap left with discontinuation of prasugrel in canada |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209390/ https://www.ncbi.nlm.nih.gov/pubmed/34169260 http://dx.doi.org/10.1016/j.cjco.2020.11.021 |
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