Adjunctive pharmacotherapy and coronary intervention

Daniel M. Shivapour, Derek P. Chew, A. Michael Lincoff

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Researchpeer-review

Abstract

It is essential for interventionists performing percutaneous coronary interventions (PCI) to have a thorough understanding of periprocedural anti-thrombotic therapies, which mitigate thrombotic as well as bleeding risks related to the procedure. Anti-platelet agents are amongst the most important adjunctive medications given in the setting of PCI, and a thorough understanding of platelet activation and interaction with vascular endothelium is needed to understand the mechanism of action of these agents. Aspirin is a cornerstone of effective anti-platelet therapy. The addition of a second oral anti-platelet agent to aspirin marked a significant advance in contemporary pharmacotherapy for PCI. Clopidogrel is an irreversible, ‘second generation’ P2Y12 receptor antagonist. As a pro-drug, it requires conversion into its active metabolite by the hepatic cytochrome P450 2C19 isoenzyme. Prasugrel is a ‘third generation’ thienopyridine that irreversibly inhibits the P2Y12 receptor. The adjunctive pharmacotherapy is used in coronary intervention a highly evidence-based discipline that is guided by decades of rigorous investigation.

Original languageEnglish
Title of host publicationPractical Interventional Cardiology
EditorsEver D. Grech
Place of PublicationBoca Raton FL USA
PublisherCRC Press
Chapter9
Pages137-153
Number of pages17
Edition3rd
ISBN (Electronic)9781498735100
ISBN (Print)9781498735094
DOIs
Publication statusPublished - 1 Jan 2017
Externally publishedYes

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