Journal
CIRCULATION
Volume 136, Issue 20, Pages 1955-+Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCULATIONAHA.117.031164
Keywords
drug interactions; hemorrhage; pharmacodynamics; platelet aggregation inhibitors; P2Y(12) receptor inhibitors; thrombosis
Funding
- Amgen
- Aralez
- AstraZeneca
- Bayer
- Biosensors
- Chiesi
- Daiichi-Sankyo
- Eli Lilly
- Janssen
- Merck
- PLx Pharma
- Pfizer
- Sanofi
- Medicines Company
- CeloNova
- St. Jude Medical
- CSL Behring
- Eisai
- Eli-Lilly
- Gilead
- Matsutani Chemical Industry Co
- Novartis
- Osprey Medical
- Renal Guard Solutions
- Scott R. MacKenzie Foundation
- National Institutes of Health/National Center for Advancing Translational Sciences [UL1 TR000064]
- National Institutes of Health/NHGRI [U01 HG007269]
- DSI/Lilly
- Roche Diagnostics
- Bayer AG
- MSD Pharma
- Amarin
- Bristol-Myers Squibb
- Ethicon
- Forest Laboratories
- Ironwood
- Ischemix
- Lilly
- Medtronic
- Roche
- Sanofi Aventis
- Boston
- Abbott
- Boston Scientific
- Biotronik
- Sanofi-Aventis
- Terumo
- Abbott Vascular
- Aspen
- Boehringer-Ingelheim
- Daiichi Sankyo
- Pharmevo
- Menarini
- Haemonetics
- DCRI
- Medicure
- National Institutes of Health
- Medimmune
- Coramed
- Boehringer
- UptoDate
- Boehringer Ingelheim
- BMS
- Lilly/Daiichi Sankyo
- Covidien
- Janssen (J+J)
- Actelion
- Beth Israel Deaconess Medical
- Brigham Women's Hospital
- Cardiovascular Research Foundation
- CCC
- Celladon
- CME Resources
- Europa
- Elsevier
- Federation Francaise de Cardiologie
- ICAN
- INSERM
- Lead-Up
- MSD
- Servier
- Janssen Pharmaceuticals
- Bayer Vital
- Astra Zeneca Canada
- PlaqueTec
- Avacta
- Bristol Myers Squibb/Pfizer
- ThermoFisher Scientific
- Berlin Chemie
- Boehringer Ingelheim KG
- Bristol Myers Squibb
- Terumo Medical
- Cordis
- Biotronik AG
- Medtronic Vascular
- Med Alliance
- Volcano Philips
- Gilead Sciences
- Regeneron
- TIMI Study Group
- WebMD
Ask authors/readers for more resources
Dual antiplatelet therapy with aspirin and a P2Y(12) inhibitor is the treatment of choice for the prevention of atherothrombotic events in patients with acute coronary syndromes and for those undergoing percutaneous coronary interventions. The availability of different oral P2Y(12) inhibitors (clopidogrel, prasugrel, ticagrelor) has enabled physicians to contemplate switching among therapies because of specific clinical scenarios. The recent introduction of an intravenous P2Y(12) inhibitor (cangrelor) further adds to the multitude of modalities and settings in which switching therapies may occur. In clinical practice, it is not uncommon to switch P2Y(12) inhibitor, and switching may be attributed to a variety of factors. However, concerns about the safety of switching between these agents have emerged. Practice guidelines have not fully elaborated on how to switch therapies, leaving clinicians with limited guidance on when and how to switch therapies when needed. This prompted the development of this expert consensus document by key leaders from North America and Europe with expertise in basic, translational, and clinical sciences in the field of antiplatelet therapy. This expert consensus provides an overview of the pharmacology of P2Y(12) inhibitors, different modalities and definitions of switching, and available literature and recommendations for switching between P2Y(12) inhibitors.
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