Pretreatment With P2Y12 Inhibitors in Contemporary Practice
The management of antiplatelet strategies among patients presenting with acute coronary syndrome (ACS) continues to evolve. Earlier studies have shown ischemic benefit with P2Y12 pretreatment in the setting of ACS; however, large-scale contemporary randomized trials supporting this strategy are lacking. This issue assumes relevance among patients with high bleeding risk or those referred for urgent/emergent coronary artery bypass surgery following coronary angiography. The evolution in the technology of percutaneous coronary intervention since the advent of newer-generation stents with lower risk of stent thrombosis is offset with their delivery in patients with high thrombotic and ischemic risk as the demographics of ACS shift towards the older age group.
