What are the benefits of P2Y12 receptor inhibitors in the management of myocardial infarction, and which are most commonly used in the treatment of non-ST-elevation acute coronary syndrome (unstable angina and NSTEMI)?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

The use of P2Y12 receptor inhibitors in addition to aspirin has resulted in better outcomes, with a reduction of the incidence of cardiovascular death, MI, and stroke. The three P2Y12 receptor inhibitors most commonly used in the treatment of NSTE-ACS are described in this section, as follows:

  • Clopidogrel
  • Ticagrelor
  • Prasugrel

All three agents are given with an initial loading dose, followed by a daily maintenance dose up to 12 months for all patients treated for NSTE ACS with either early invasive or conservative strategies.

With the wider use of new generation drug-eluting stents (DES), a shorter duration of P2Y12 receptor inhibitors of 3-6 months can be considered in patients who are at high bleeding risk.


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