%0 Journal Article
%T De
%A Charalambos Varlamos
%A Danai Sfantou
%A Dimitrios Alexopoulos
%A Ioannis Lianos
%A Panagiotis Vlachakis
%A Vassiliki-Maria Dragona
%J Journal of Cardiovascular Pharmacology and Therapeutics
%@ 1940-4034
%D 2019
%R 10.1177/1074248418823724
%X In patients with an acute coronary syndrome undergoing percutaneous coronary intervention, novel P2Y12 receptor inhibitors, prasugrel and ticagrelor, are proposed as ˇ°first-lineˇ± antiplatelet agents in the absence of contraindications and up to a year from the index event. However, de-escalation of treatment to clopidogrel occurs with a variable frequency in real-life practice, most commonly due to an increased bleeding potential, more frequent side effects, and a higher cost for the novel agents. Pharmacodynamic studies provide most of the data on guidance for de-escalation. Despite positive messages from recent trials and registries, lack of definitive efficacy or safety results of such a strategy remains an obstacle to suggest de-escalation in a routine basis. Carefully designed studies are likely to improve our understanding of the impact of de-escalation and help to better define its position in current pharmacotherapy
%K antiplatelet treatment
%K P2Y12 inhibitors
%K switching
%U https://journals.sagepub.com/doi/full/10.1177/1074248418823724