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Volume 11
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10.3390/jcm11237211
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Review

Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?

by
Peter Blaško
1,2,
Matej Samoš
1,*,
Tomáš Bolek
1,
Lucia Stančiaková
3,
Ingrid Škorňová
3,
Martin Jozef Péč
1,
Jakub Jurica
1,
Ján Staško
3 and
Marián Mokáň
1
1
Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 59 Martin, Slovakia
2
Out-Patient Clinic of Cardiology, 957 01 Banovce nad Bebravou, Slovakia
3
Department of Hematology and Blood Transfusion, National Centre of Hemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 59 Martin, Slovakia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2022, 11(23), 7211; https://doi.org/10.3390/jcm11237211
Submission received: 28 September 2022 / Revised: 12 November 2022 / Accepted: 2 December 2022 / Published: 4 December 2022
(This article belongs to the Special Issue Management of Venous and Arterial Thrombosis)
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Abstract

Novel P2Y12 ADP receptor blockers (ADPRB) should be preferred in dual-antiplatelet therapy in patients with acute coronary syndrome. Nevertheless, there are still patients who do not respond optimally to novel ADP receptor blocker therapy, and this nonoptimal response (so-called “high on-treatment platelet reactivity” or “resistance”) could be connected with increased risk of adverse ischemic events, such as myocardial re-infarction, target lesion failure and stent thrombosis. In addition, several risk factors have been proposed as factors associated with the phenomenon of inadequate response on novel ADPRB. These include obesity, multivessel coronary artery disease, high pre-treatment platelet reactivity and impaired metabolic status for prasugrel, as well as elderly, concomitant therapy with beta-blockers, morphine and platelet count for ticagrelor. There is no literature report describing nonoptimal therapeutic response on cangrelor, and cangrelor therapy seems to be a possible approach for overcoming HTPR on prasugrel and ticagrelor. However, the optimal therapeutic management of “resistance” on novel ADPRB is not clear and this issue requires further research. This narrative review article discusses the phenomenon of high on-treatment platelet reactivity on novel ADPRB, its importance in clinical practice and approaches for its therapeutic overcoming.
Keywords: prasugrel; ticagrelor; cangrelor; high on-treatment platelet reactivity; stent thrombosis; acute coronary syndrome prasugrel; ticagrelor; cangrelor; high on-treatment platelet reactivity; stent thrombosis; acute coronary syndrome

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MDPI and ACS Style

Blaško, P.; Samoš, M.; Bolek, T.; Stančiaková, L.; Škorňová, I.; Péč, M.J.; Jurica, J.; Staško, J.; Mokáň, M. Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth? J. Clin. Med. 2022, 11, 7211. https://doi.org/10.3390/jcm11237211

AMA Style

Blaško P, Samoš M, Bolek T, Stančiaková L, Škorňová I, Péč MJ, Jurica J, Staško J, Mokáň M. Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth? Journal of Clinical Medicine. 2022; 11(23):7211. https://doi.org/10.3390/jcm11237211

Chicago/Turabian Style

Blaško, Peter, Matej Samoš, Tomáš Bolek, Lucia Stančiaková, Ingrid Škorňová, Martin Jozef Péč, Jakub Jurica, Ján Staško, and Marián Mokáň. 2022. "Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth?" Journal of Clinical Medicine 11, no. 23: 7211. https://doi.org/10.3390/jcm11237211

APA Style

Blaško, P., Samoš, M., Bolek, T., Stančiaková, L., Škorňová, I., Péč, M. J., Jurica, J., Staško, J., & Mokáň, M. (2022). Resistance on the Latest Oral and Intravenous P2Y12 ADP Receptor Blockers in Patients with Acute Coronary Syndromes: Fact or Myth? Journal of Clinical Medicine, 11(23), 7211. https://doi.org/10.3390/jcm11237211

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