Managing the acute coronary syndrome patient: Evidence based recommendations for anti-platelet therapy

Heart and Lung

Volumn 44, Issue 2, 2015, Pages 141-149

  Clark, Michael G ^a   Beavers, Craig ^b   Osborne, John ^a  

^a Heart Center of North Texas   (United States)

^b CENTENNIAL MEDICAL CENTER   (United States)

Author keywords

Acute coronary syndrome; Clopidogrel; Myocardial infarction; Prasugrel; Ticagrelor; Unstable angina

Indexed keywords

ACETYLSALICYLIC ACID; ANTITHROMBOCYTIC AGENT; CLOPIDOGREL; PRASUGREL; TICAGRELOR;

ACUTE CORONARY SYNDROME; ANTICOAGULANT THERAPY; CLINICAL PRACTICE; EVIDENCE BASED PRACTICE; HOSPITAL DISCHARGE; HUMAN; NON ST SEGMENT ELEVATION ACUTE CORONARY SYNDROME; NON ST SEGMENT ELEVATION MYOCARDIAL INFARCTION; PATIENT CARE; PATIENT SELECTION; PHARMACIST; PRACTICE GUIDELINE; PRIORITY JOURNAL; REVIEW; RISK BENEFIT ANALYSIS; ST SEGMENT ELEVATION MYOCARDIAL INFARCTION; UNSTABLE ANGINA PECTORIS; ANGINA, UNSTABLE; MYOCARDIAL INFARCTION; UNITED STATES;

ACUTE CORONARY SYNDROME; ANGINA, UNSTABLE; HUMANS; MYOCARDIAL INFARCTION; PLATELET AGGREGATION INHIBITORS; PRACTICE GUIDELINES AS TOPIC; UNITED STATES;

EID: 84924580405     PISSN: 01479563     EISSN: 15273288     Source Type: Journal    
DOI: 10.1016/j.hrtlng.2014.11.005     Document Type: Review

References (50)

1. Amsterdam E.A., Wenger N.K., Brindis R.G., et al. 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014, published online before print September 23 2014. 10.1161/CIR.0000000000000134.
2. Kumar A., Cannon C.P. Acute coronary syndromes: diagnosis and management, Part I. Mayo Clin Proc 2009, 84(10):917-938.
3. Hamm C.W., Heeschen C., Falk E., Fox K.A.A. Acute coronary syndromes: pathophysiology, diagnosis and risk stratification. The ESC Textbook of Cardiovascular Medicine 2009, 333-366. Oxford University Press, Oxford, UK. 2nd ed. A.J. Cam, T.F. Lüscher, P.W. Serruys (Eds.).
4. Go A.S., Mozaffarian D., Roger V.L., et al. Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation 2014, 129(3):e28-e292.
5. O'Gara P.T., Kushner F.G., Ascheim D.D., et al. 2013 ACCF/AHA guideline for the management of st-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. JAm Coll Cardiol 2013, 61(4):e78-e140.
6. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002, 324:71-86. Antithrombotic Trialists' Collaboration.
7. Ellrodt G., Clasener R., Cadorette B., et al. Multidisciplinary rounds (MDR): an implementation system for sustained improvement in the American Heart Association's Get With the Guidelines programs. Crit Cardiol 2007, 6(3):106-116.
8. Brindis R., Rodgers G.P., Handbery President's page: team-based care: a solution for our health care delivery challenges. JAm Coll Cardiol 2011, 57(9):1123-1125.
9. Morrow D.A., Fang J.C., Fintel D.J., et al. Evolution of critical care cardiology: transformation of the cardiovascular intensive care unit and the emerging need for new medical staffing and training models: a scientific statement from the American Heart Association. Circulation 2012, 126(11):1408-1428.
10. Methodology Manual and Policies From the ACCF/AHA Task Force on Practice Guidelines 2009, ACCF/AHA Task Force on Practice Guidelines, Available at:, Accessed 28.08.13. http://assets.cardiosource.com/Methodology_Manual_for_ACC_AHA_Writing_Committees.pdf.
11. Anderson J.L., Adams C.D., Antman E.M., et al. 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-st-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013, 127(23):e663-e828. Erratum in Circulation. 2013;127(24):e863-e864.
12. 12 inhibitors. Circulation 2010, 121(1):171-179.
13. Brilinta prescribing information. AstraZeneca, LP., Wilmington, DE, USA. Available at: ; Accessed 03.10.13. http://www1.astrazeneca-us.com/pi/brilinta.pdf.
14. Bristol-Myers Squibb Sanofi-aventis, Accessed 03.10.13.
15. Effient (Prasugrel) [Package Insert] 2012, Eli Lilly and Co, Daiichi Sankyo, Inc.
16. Abraham N.S., Hlatky M.A., Antman E.A., et al. ACCF/ACG/AHA 2010 expert consensus document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation 2010, 122(24):2619-2633.
17. Antman E.M., Anbe D.T., Armstrong P.W., et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation 2004, 110(9):e82-e292.
18. Mehta S.R., Bassand J.P., Chrolavicius S., et al. Dose comparisons of clopidogrel and aspirin in acute coronary syndromes. NEngl J Med 2010, 363(1):930-942. CURRENT-OASIS 7 Investigators.
19. Mehta S.R., Tanguay J.F., Eikelboom J.W., et al. Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial study. Lancet 2010, 376(9748):1233-1243.
20. Patti G., Bárczi G., Orlic D., et al. Outcome comparison of 600- and 300-mg loading doses of clopidogrel in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Results from the ARMYDA-6 MI (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty-Myocardial Infarction) randomized study. JAm Coll Cardiol 2011, 58(15):1592-1599.
21. Kushner F.G., Hand M., Smith S.C., et al. 2009 Focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2009, 120(22):2271-2306.
22. Cuisset T., Frere C., Quilici J., et al. Benefit of a 600-mg loading dose of clopidogrel on platelet reactivity and clinical outcomes in patients with non-ST-segment elevation acute coronary syndrome undergoing coronary stenting. JAm Coll Cardiol 2006, 48(7):1339-1345.
23. O'Donoghue M., Wiviott S.D. Clopidogrel response variability and future therapies: clopidogrel: does one size fit all?. Circulation 2006, 114:e600-e606.
24. Frelinger A.L., Bhatt D.L., Lee R.D., et al. Clopidogrel pharmacokinetics and pharmacodynamics vary widely despite exclusion or control of polymorphisms (CYP2C19, ABCB1, PON1), noncompliance, diet, smoking, co-medications (including proton pump inhibitors), and pre-existing variability in platelet function. JAm Coll Cardiol 2013, 61(8):872-879.
25. Wiviott S.D., Braunwald E., McCabe C.H., et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. NEngl J Med 2007, 357(20):2001-2015.
26. Wallentin L., Becker R.C., Budaj A., et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. NEngl J Med 2009, 361(11):1045-1057.
27. Montalescot G., Wiviott S.D., Braunwald E., et al. Prasugrel compared with clopidogrel in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (TRITON-TIMI 38): double-blind, randomised controlled trial. Lancet 2009, 373(9665):723-731.
28. Steg P.G., James S., Harrington R.A., et al. Ticagrelor versus clopidogrel in patients with ST-elevation acute coronary syndromes intended for reperfusion with primary percutaneous coronary intervention: a Platelet Inhibition and Patient Outcomes (PLATO) Trial subgroup analysis. Circulation 2010, 122(21):2131-2141.
29. Mahaffey K.W., Wojdyla D.M., Carroll K., et al. Ticagrelor compared with clopidogrel by geographic region in the Platelet Inhibition and Patient Outcomes (PLATO) trial. Circulation 2011, 124(5):544-554.
30. Gurbel P.A., Bliden K.P., Butler K., et al. Randomized double-blind assessment of ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study. Circulation 2009, 120(25):2577-2585.
31. Wallentin L., Vernhorst C., James S., et al. Prasugrel achieves greater and faster P2Y12 receptor-mediated platelet inhibition than clopidogrel due to more efficient generation of its active metabolite in aspirin-treated patients with coronary artery disease. Eur Heart J 2008, 29(1):21-30.
32. Price M.J., Walder J.S., Baker B.A., et al. Recovery of platelet function after discontinuation of prasugrel or clopidogrel maintenance dosing in aspirin-treated patients with stable coronary artery disease: the Recovery Trial. JAm Coll Cardiol 2012, 59(25):2338-2343.
33. Holmes D.R., Dehmer G.J., Kaul S., Leifer D., O'Gara P.T., Stein C.M. ACCF/AHA clopidogrel clinical alert: approaches to the FDA "Boxed warning": a report of the American college of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the American Heart Association. Circulation 2010, 122(5):537-557.
34. CYP2C19 Test: Product Information. Nanosphere, Inc. Available at: ; Accessed 14.11.14. http://www.nanosphere.us/products/cyp2c19-test.
35. Spartan RX CYP2C19 System: Product Information. Spartan Bioscience Inc. Available at: ; Accessed 14.11.14. http://www.spartanbio.com/products/spartan-rx/performance/.
36. Grines C.L., Bonow R.O., Casey D.E., et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Intervention, American college of Surgeons, and American Dental Association, with presentation from the American College of Physicians. JAm Coll Cardiol 2007, 49(6):734-739.
37. Iakovou I., Schmidt T., Bonizzoni E., et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAm Med Assoc 2005, 293(17):2126-2130.
38. Spertus J.A., Kettelkamp R., Vance C., et al. Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER Registry. Circulation 2006, 113(24):2803-2809.
39. Douketis J.D., Spyropoulos A.C., Spencer F.A., et al. Perioperative management of antithrombotic therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012, 141(2 suppl):e326S-e350S.
40. American Dental Association. Anticoagulant, Antiplatelet Medications andDental Procedures. Available from: ; Accessed 24.09.13. http://www.ada.org/2526.aspx?currentTab=2.
41. Guideline: management of antithrombotic agents for endoscopic procedures. Gastrointest Endosc 2009, 70(6):1061-1070. American Society for Gastrointestinal Endoscopy.
42. January C.T., Wann L.S., Alpert J.S., et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary. JAm Coll Cardiol 2014.
43. Peters R.J.G., Mehta S.R., Fox K.A.A., et al. Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: observations from the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Study. Circulation 2003, 108(14):1682-1687.
44. Gehi A., Haas D., Pipkin S., Whooley M.A. Depression and medication adherence in outpatients with coronary heart disease: findings from the Heart and Soul Study. Arch Intern Med 2005, 165(21):2508-2513.
45. Kulkarni S.P., Alexander K.P., Lytle B., Heiss G., Peterson E.D. Long-term adherence with cardiovascular drug regimens. Am Heart J 2006, 151(1):185-191.
46. Gurbel P.A., Bliden K.P., Butler K., et al. Response to ticagrelor in clopidogrel nonresponders and responders and effect of switching therapies: the RESPOND Study. Circulation 2010, 121(10):1188-1199.
47. Angiolillo D.J., Saucedo J.F., DeRaad R., et al. Increased platelet inhibition after switching from maintenance clopidogrel to prasugrel in patients with acute coronary syndromes: results of the SWAP (SWitching Anti Platelet) Study. JAm Coll Cardiol 2010, 56(13):1017-1023.
48. Alexopoulos D., Galati A., Xanthopoulou I., et al. Ticagrelor versus prasugrel in acute coronary syndrome patients with high on-clopidogrel platelet reactivity following percutaneous coronary intervention: a pharmacodynamic study. JAm Coll Cardiol 2012, 60(3):193-199.
49. Angiolillo D.J., Curzen N., Gurbel P., et al. Pharmacodynamic evaluation of switching from ticagrelor to prasugrel in patients with stable coronary artery disease: results of the SWAP-2 Study (Switching Anti Platelet-2). JAm Coll Cardiol 2014, 63(15):1500-1509.
50. Scott S.A., Sangkuhl K., Stein C.M., et al. Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update. Clin Pharmacol Ther 2013, 94(3):317-323.