Switching Platelet P2Y12 Receptor Inhibiting Therapies.

Interventional cardiology clinics Pub Date : 2024-10-01 Epub Date: 2024-12-04 DOI:10.1016/j.iccl.2024.11.001
Luis Ortega-Paz, Fabiana Rollini, Francesco Franchi, Dirk Sibbing, Dominick J Angiolillo
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Abstract

Antiplatelet therapy involving aspirin and a P2Y12 receptor inhibitor is fundamental in managing patients with atherothrombotic disease. Switching between P2Y12 inhibitors is frequently observed in clinical settings for various reasons, such as safety, efficacy, patient adherence, or cost concerns. Although it occurs often, the optimal method for switching remains a concern owing to potential drug interactions, which can result in either inadequate platelet inhibition and subsequent thrombotic events or low platelet reactivity and increased bleeding risks due to therapy overlap. This review offers practical guidance on switching P2Y12 inhibitors, drawing from pharmacodynamic and clinical data.

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使用阿司匹林和 P2Y12 受体抑制剂的抗血小板疗法是治疗动脉粥样硬化血栓性疾病患者的基础。由于安全性、疗效、患者依从性或成本等各种原因,临床上经常出现 P2Y12 抑制剂之间的转换。虽然这种情况经常发生,但由于潜在的药物相互作用,切换的最佳方法仍然令人担忧,因为这可能导致血小板抑制不足,继而引发血栓事件,或导致血小板反应性低下,因治疗重叠而增加出血风险。本综述从药效学和临床数据出发,为 P2Y12 抑制剂的转换提供实用指导。
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