title: Effectiveness of Pretreatment With Dual Oral Antiplatelet Therapy.
abstract: Several observational studies, randomized controlled trials, and meta-analyses suggested that pretreatment with clopidogrel in addition to aspirin could reduce the rate of ischemic events, especially in the setting of acute coronary syndromes. Newer P2Y12 inhibitors like prasugrel and ticagrelor, which provide faster and stronger platelet inhibition compared with clopidogrel, would enhance the benefits of pretreatment. However, 2 recent randomized trials, A Comparison of Prasugrel at PCI or Time of Diagnosis of Non-ST Elevation Myocardial Infarction and the Administration of Ticagrelor in the Cath Lab or in the Ambulance for New ST Elevation Myocardial Infarction to Open the Coronary Artery studies, aimed at assessing the effects of the timing of administration of novel P2Y12 inhibitors in acute coronary syndromes, failed to meet their primary end points. In this report, we review clinical data on pretreatment with dual oral antiplatelet therapy and comment on some criticisms raised from recent trials.
authors.affiliation: Department of Cardiovascular Sciences, European Hospital, Rome, Italy. Electronic address: leo.deluca@libero.it.
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.affiliation: Department of Cardiology, European Hospital Georges-Pompidiou, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.affiliation: Department of Emergency Medicine, CHRU de Lille, Lille, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Goldstein
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D006801:Humans; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011292:Premedication; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists