title: [Differentiated antiplatelet therapy for acute coronary syndromes].
abstract: Dual antiplatelet therapy is the cornerstone of maintenance medication following invasive treatment of patients with acute coronary syndromes (ST elevation myocardial infarction, non-ST elevation myocardial infarction, unstable angina). Over the last decade, P2Y12 inhibition in addition to low-dose acetylsalicylic acid has been intensively debated. The debate was enriched by the results of the large phase III clinical trials for prasugrel (TRITON) and ticagrelor (PLATO) compared to clopidogrel in patients with acute coronary syndromes. This article summarizes the critical details und subanalyses of both study programmes and highlights on clinical decision making when using the three P2Y12 blockers in acute coronary syndromes. A special focus is on higher risk patients such as those with ST elevation myocardial infarction and those with coexisting diabetes, but also on minimizing relevant bleedings, which are common during more intense platelet inhibition.
authors.affiliation: Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover.
authors.forename: A
authors.initials: A
authors.lastname: Schäfer
authors.affiliation: Klinik für Kardiologie und Pulmologie, Campus Benjamin Franklin, Charité Berlin.
authors.forename: H R
authors.initials: HR
authors.lastname: Arntz
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Universität Leipzig - Herzzentrum.
authors.forename: E
authors.initials: E
authors.lastname: Boudriot
authors.affiliation: Medizinische Klinik 2, Universitätsklinikum Erlangen.
authors.forename: C
authors.initials: C
authors.lastname: Garlichs
authors.affiliation: Klinik für Innere Medizin - Kardiologie, allgemeine Innere Medizin und konserv. Intensivmedizin, Vivantes Klinikum Friedrichshain, Berlin.
authors.forename: S
authors.initials: S
authors.lastname: Hoffmann
authors.affiliation: Klinik für Innere Medizin - Kardiologie, allgemeine Innere Medizin und konserv. Intensivmedizin, Vivantes Klinikum Friedrichshain, Berlin.
authors.forename: H
authors.initials: H
authors.lastname: Ince
authors.affiliation: Praxis für Kardiologie in Bonn.
authors.forename: T
authors.initials: T
authors.lastname: Klingenheben
authors.affiliation: Medizinische Klinik II, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
authors.forename: J
authors.initials: J
authors.lastname: Weil
authors.affiliation: Praxis für Kardiologie, Straubing.
authors.forename: C
authors.initials: C
authors.lastname: Zugck
authors.affiliation: Deutsche Stiftung für chronisch Kranke, Hamburg.
authors.forename: T M
authors.initials: TM
authors.lastname: Helms
authors.affiliation: Praxis in der Klinik Dr. Müller, München.
authors.forename: S
authors.initials: S
authors.lastname: Silber
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000241:Adenosine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000789:Angina, Unstable / Q000188:drug therapy; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D001792:Blood Platelets / Q000187:drug effects; D000077144:Clopidogrel; D006470:Hemorrhage / Q000097:blood / Q000139:chemically induced; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D017713:Platelet Transfusion; D000068799:Prasugrel Hydrochloride; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use; D000077486:Ticagrelor; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D013876:Thiophenes; D000077144:Clopidogrel; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine; D001241:Aspirin