Bridging the gap: Current and future insights for improving suboptimal platelet inhibition in STEMI

A.H. Tavenier, R.S. Hermanides*, E. Fabris, D.J. Angiolillo, A.W.J. van't Hof

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)

Abstract

Antiplatelet therapy is one of the cornerstones in the acute treatment of patients with ST-elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI). However, hemodynamic changes and delayed intestinal absorption of P2Y12 inhibitors leads to a delay in the onset of antiplatelet effects resulting in a gap of platelet inhibition. Several strategies have been proposed to bridge this gap, such as pre-hospital administration of antiplatelet therapy, higher loading doses of P2Y12 inhibitors, crushing or chewing tablets, subcutaneous or intravenous administration of platelet inhibitors, or use of pain relievers alternative to opioids that do not delay intestinal absorption of oral platelet inhibitors. These strategies may improve platelet inhibition with the goal of optimizing clinical outcomes in the acute phase of STEMI. In this review we present current and future insights for bridging the gap in platelet inhibition in STEMI patients undergoing primary PCI. (c) 2020 Published by Elsevier B.V.<comment>Superscript/Subscript Available</comment
Original languageEnglish
Pages (from-to)40-45
Number of pages6
JournalInternational Journal of Cardiology
Volume328
DOIs
Publication statusPublished - 1 Apr 2021

Keywords

  • Antiplatelet therapy
  • STEMI
  • Glycoprotein IIb
  • IIIa inhibitors
  • ST-SEGMENT-ELEVATION
  • PERCUTANEOUS CORONARY INTERVENTION
  • GLYCOPROTEIN IIB/IIIA INHIBITORS
  • MYOCARDIAL-INFARCTION PATIENTS
  • LONG-TERM MORTALITY
  • HIGH-DOSE TIROFIBAN
  • PRIMARY PCI
  • PREHOSPITAL TICAGRELOR
  • ANTIPLATELET ACTION
  • TASK-FORCE

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