Читать книгу Interventional Cardiology - Группа авторов - Страница 318

According to ESC/AHA guidelines, patients undergoing primary PCI should receive DAPT (i.e. a combination of aspirin and a P2Y12 inhibitor), and a parenteral anticoagulant during PCI [3,4].

The 3rd generation thienopyridine prasugrel and the reversible P2Y12 inhibitor ticagrelor have largely replaced the 2nd generation thienopyridine clopidogrel apart from in a select few situations (age >75 years, weight <60 kg, prior stroke or TIA, in the setting of oral anticoagulant use, excessive risk of bleeding), given its relatively slow onset of action and large variability in inter‐patient response. Where clopidogrel is used, it is recommended that a 600 mg loading dose be used, given the evidence of faster onset of action and less inter‐patient variability at this dose [41].