Escalation and de-escalation of dual antiplatelet therapy in patients with acute coronary syndrome

Shamraev R. L., Ilukhin O. V., Lopatin Y. M.

Dual anti-platelet therapy (DAAT) using aspirin and a P2Y12 inhibitor of the platelet receptor is included in the standard of care for patients with acute coronary syndrome. It is known that stronger drugs - ticagrelor and prasugrel significantly reduce ischemic events compared with clopidogrel, while their use is associated with an increased risk of bleeding. Therefore, in clinical practice, there is often a switch from one drug to another, but there are no official documents and recommendations on this issue. In this review, we have covered the major major works on the issue of escalation / de-escalation of DAAT lately.

Keywords:DAAT escalation, DAAT de-escalation, clopidogrel, ticagrelor, prasugrel