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Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?

Novel P2Y12 ADP receptor blockers (ADPRB) should be preferred in dual-antiplatelet therapy in patients with acute coronary syndrome. Nevertheless, there are still patients who do not respond optimally to novel ADP receptor blocker therapy, and this nonoptimal response (so-called “high on-treatment p...

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Autores principales: Blaško, Peter, Samoš, Matej, Bolek, Tomáš, Stančiaková, Lucia, Škorňová, Ingrid, Péč, Martin Jozef, Jurica, Jakub, Staško, Ján, Mokáň, Marián
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737839/
https://www.ncbi.nlm.nih.gov/pubmed/36498785
http://dx.doi.org/10.3390/jcm11237211
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author Blaško, Peter
Samoš, Matej
Bolek, Tomáš
Stančiaková, Lucia
Škorňová, Ingrid
Péč, Martin Jozef
Jurica, Jakub
Staško, Ján
Mokáň, Marián
author_facet Blaško, Peter
Samoš, Matej
Bolek, Tomáš
Stančiaková, Lucia
Škorňová, Ingrid
Péč, Martin Jozef
Jurica, Jakub
Staško, Ján
Mokáň, Marián
author_sort Blaško, Peter
collection PubMed
description Novel P2Y12 ADP receptor blockers (ADPRB) should be preferred in dual-antiplatelet therapy in patients with acute coronary syndrome. Nevertheless, there are still patients who do not respond optimally to novel ADP receptor blocker therapy, and this nonoptimal response (so-called “high on-treatment platelet reactivity” or “resistance”) could be connected with increased risk of adverse ischemic events, such as myocardial re-infarction, target lesion failure and stent thrombosis. In addition, several risk factors have been proposed as factors associated with the phenomenon of inadequate response on novel ADPRB. These include obesity, multivessel coronary artery disease, high pre-treatment platelet reactivity and impaired metabolic status for prasugrel, as well as elderly, concomitant therapy with beta-blockers, morphine and platelet count for ticagrelor. There is no literature report describing nonoptimal therapeutic response on cangrelor, and cangrelor therapy seems to be a possible approach for overcoming HTPR on prasugrel and ticagrelor. However, the optimal therapeutic management of “resistance” on novel ADPRB is not clear and this issue requires further research. This narrative review article discusses the phenomenon of high on-treatment platelet reactivity on novel ADPRB, its importance in clinical practice and approaches for its therapeutic overcoming.
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spelling pubmed-97378392022-12-11 Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth? Blaško, Peter Samoš, Matej Bolek, Tomáš Stančiaková, Lucia Škorňová, Ingrid Péč, Martin Jozef Jurica, Jakub Staško, Ján Mokáň, Marián J Clin Med Review Novel P2Y12 ADP receptor blockers (ADPRB) should be preferred in dual-antiplatelet therapy in patients with acute coronary syndrome. Nevertheless, there are still patients who do not respond optimally to novel ADP receptor blocker therapy, and this nonoptimal response (so-called “high on-treatment platelet reactivity” or “resistance”) could be connected with increased risk of adverse ischemic events, such as myocardial re-infarction, target lesion failure and stent thrombosis. In addition, several risk factors have been proposed as factors associated with the phenomenon of inadequate response on novel ADPRB. These include obesity, multivessel coronary artery disease, high pre-treatment platelet reactivity and impaired metabolic status for prasugrel, as well as elderly, concomitant therapy with beta-blockers, morphine and platelet count for ticagrelor. There is no literature report describing nonoptimal therapeutic response on cangrelor, and cangrelor therapy seems to be a possible approach for overcoming HTPR on prasugrel and ticagrelor. However, the optimal therapeutic management of “resistance” on novel ADPRB is not clear and this issue requires further research. This narrative review article discusses the phenomenon of high on-treatment platelet reactivity on novel ADPRB, its importance in clinical practice and approaches for its therapeutic overcoming. MDPI 2022-12-04 /pmc/articles/PMC9737839/ /pubmed/36498785 http://dx.doi.org/10.3390/jcm11237211 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Blaško, Peter
Samoš, Matej
Bolek, Tomáš
Stančiaková, Lucia
Škorňová, Ingrid
Péč, Martin Jozef
Jurica, Jakub
Staško, Ján
Mokáň, Marián
Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?
title Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?
title_full Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?
title_fullStr Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?
title_full_unstemmed Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?
title_short Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?
title_sort resistance on the latest oral and intravenous p2y12 adp receptor blockers in patients with acute coronary syndromes: fact or myth?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737839/
https://www.ncbi.nlm.nih.gov/pubmed/36498785
http://dx.doi.org/10.3390/jcm11237211
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