Email Artikel ini REVIEW ARTIKEL: EFIKASI, KEAMANAN, DAN DURASI PENGGUNAAN ANTIPLATELET GOLONGAN P2Y12 INHIBITOR PADA PASIEN SINDROM KORONER AKUT
Sari
Sindroma koroner akut (SKA), termasuk unstable angina (UA) dan infark miokard (IM) merupakan manifestasi penyakit jantung koroner. Penyakit jantung koroner merupakan penyebab kematian terbesar pada kasus kardiovaskular sehingga diperlukan penanganan dan terapi yang adekuat. Terapi antiplatelet merupakan terapi utama dalam manajemen penanganan sindroma koroner akut. Dual antiplatelet therapy (DAPT) adalah standar terapi da SKA. Antiplatelet golongan P2Y12 inhibitor merupakan salah satu komponen penting dalam DAPT. Adanya risiko perdarahan dan kejadian iskemia yang dapat terjadi selama terapi dengan P2Y12 inhibitor membuat pemilihan P2Y12 inhibitor menjadi suatu yang krusial. Pemilihan jenis obat dan durasi antiplatelet P2Y12 inhibitor tidak hanya mempertimbangkan efikasi, seperti MACE, tetapi juga perlu mempertimbangkan keamanan pasien, seperti kejadian, major bleeding, dan kejadian iskemia. Review artikel ini akan membahas terkait efikasi, keamanan, serta durasi dari penggunaan P2Y12 inhibitor pada pasien SKA berdasarkan bukti-bukti klinis.
Kata Kunci
Teks Lengkap:
PDFReferensi
Byrne, R.A. et al. (2023) ‘2023 ESC Guidelines for the management of acute coronary syndromes’, European Heart Journal Available at:
https://doi.org/10.1093/eurheartj/ehad191.
Capranzano, P. and Angiolillo, D.J. (2020) ‘Ticagrelor or Clopidogrel in Elderly Patients With Myocardial Infarction: When the Choice Makes the Difference’, Circulation, 142(18), pp. 1709–1712. Available at:
https://doi.org/10.1161/CIRCULATIONAHA.120.050845.
Chenna, V.S.H. et al. (2023) ‘Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndrome and on Dialysis: A Meta-Analysis’, Cureus, 15(6). Available at: https://doi.org/10.7759/cureus.40211.
Chisholm-Burns, M.A. et al. (2016) Pharmacotherapy Principles & Practice. 4th edn. New York: McGraw-Hill Education.
Choi, Y. et al. (2022) ‘Ticagrelor Versus Clopidogrel in East Asian Patients With Acute Coronary Syndrome and Diabetes Mellitus’, JACC: Asia, 2(6), pp. 666–674. Available at:
https://doi.org/10.1016/j.jacasi.2022.07.005.
Collet, J.P. et al. (2021) ‘2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation’, European Heart Journal. Oxford University Press, pp. 1289–1367. Available at: https://doi.org/10.1093/eurheartj/ehaa575.
Hahn, J.Y. et al. (2018) ‘6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial’, The Lancet, 391(10127), pp. 1274–1284. Available at: https://doi.org/10.1016/S0140-6736(18)30493-8.
Husted, S. et al. (2012) ‘Ticagrelor versus clopidogrel in elderly patients with acute coronary syndromes: A substudy from the prospective randomized PLATelet inhibition and patient Outcomes (PLATO) trial’, Circulation: Cardiovascular Quality and Outcomes, 5(5), pp. 680–688. Available at: https://doi.org/10.1161/CIRCOUTCOMES.111.964395.
Juzar, D.A. et al. (2018) ‘Tata Laksana Sindrome Koroner Akut’, Perhimpunan Dokter Spesialis Kardiovaskular Indonesia, 4.
Koo, B.K. et al. (2021) ‘Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial’, The Lancet, 397(10293), pp. 2487–2496. Available at: https://doi.org/10.1016/S0140-6736(21)01063-1.
Krakowiak, A. et al. (2020) ‘Ticagrelor-Related Severe Dyspnoea: Mechanisms, Characteristic Features, Differential Diagnosis and Treatment’, Clinical Medicine Insights: Case Reports, 13. Available at: https://doi.org/10.1177/1179547620956634.
Kuno, T. et al. (2021) ‘Optimal Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome: Insights From a Network Meta-Analysis of Randomized Trials’, Cardiovascular Revascularization Medicine, 28, pp. 50–56. Available at: https://doi.org/10.1016/j.carrev.2020.07.039.
Lam, A.S.M., Yan, B.P.Y. and Lee, V.W.Y. (2021) ‘Efficacy and safety comparing prasugrel/ticagrelor and clopidogrel in Hong Kong post-acute coronary syndrome patients–A 10-year cohort study’, Clinical Cardiology, 44(8), pp. 1072–1079. Available at: https://doi.org/10.1002/clc.23653.
Lee, K.-S. et al. (2023) ‘Prasugrel dose de-escalation in diabetic patients with acute coronary syndrome receiving percutaneous coronary intervention: results from the HOST-REDUCE-POLYTECH-ACS trial ’, European Heart Journal - Cardiovascular Pharmacotherapy, 9(3), pp. 262–270.
Misumida, N. et al. (2018) ‘Efficacy and safety of short-term dual antiplatelet therapy (≤6 months) after percutaneous coronary intervention for acute coronary syndrome: A systematic review and meta-analysis of randomized controlled trials’, Clinical Cardiology. John Wiley and Sons Inc., pp. 1455–1462. Available at:
https://doi.org/10.1002/clc.23075.
Palmerini, T. et al. (2017) ‘Three, six, or twelve months of dual antiplatelettherapy after DES implantation in patients withor without acute coronary syndromes: anindividual patient data pairwise and networkmeta-analysis of six randomized trials and11 473 patients’, European Heart Journal, 38(14), pp. 1034–1043. Available at:
https://doi.org/10.1093/eurheartj/ehx110.
Palmerini, T. et al. (2019) ‘Risk-benefit profile of longer-than-1-year dual-antiplatelet therapy duration after drug-eluting stent implantation in relation to clinical presentation a pairwise meta-analysis of 6 trials and 21 457 patients’, Circulation: Cardiovascular Interventions, 12(3). Available at:
https://doi.org/10.1161/CIRCINTERVENTIONS.118.007541.
Pareek, M. and Bhatt, D.L. (2018) ‘Dual antiplatelet therapy in patients with an acute coronary syndrome: Up to 12 months and beyond’, European Heart Journal, Supplement, 20, pp. B21–B28. Available at: https://doi.org/10.1093/eurheartj/sux042.
Park, S. et al. (2021) ‘P2Y12 antiplatelet choice for patients with chronic kidney disease and acute coronary syndrome: A systematic review and meta-analysis’, Journal of Personalized Medicine, 11(3). Available at: https://doi.org/10.3390/jpm11030222.
Peyracchia, M. et al. (2020) ‘Efficacy and Safety of Clopidogrel, Prasugrel and Ticagrelor in ACS Patients Treated with PCI: A Propensity Score Analysis of the RENAMI and BleeMACS Registries’, American Journal of Cardiovascular Drugs, 20(3), pp. 259–269. Available at:
https://doi.org/10.1007/s40256-019-00373-1
De Rosa, R. et al. (2019) ‘Antiplatelet therapy in very elderly and comorbid patients with acute coronary syndromes’, Journal of Geriatric Cardiology, 16(2), pp. 103–113. Available at:
https://doi.org/10.11909/j.issn.1671-5411.2019.02.006.
De Rosa, R. et al. (2019) ‘Antiplatelet therapy in very elderly and comorbid patients with acute coronary syndromes’, Journal of Geriatric Cardiology, 16(2), pp. 103–113. Available at:
https://doi.org/10.11909/j.issn.1671-5411.2019.02.006.
Roth, G.A. et al. (2020) ‘Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study’, Journal of the American College of Cardiology. Elsevier Inc., pp. 2982–3021. Available at:
https://doi.org/10.1016/j.jacc.2020.11.010.
Sampat, P.J. and Wadhwa, R. (2023) ‘Prasugrel’, NCBI-StatPearls, pp. 1–7.
Schunkert, H. et al. (2019) ‘Randomized trial of ticagrelor vs. aspirin in patients after coronary artery bypass grafting: the TiCAB trial’, European Heart Journal, 40(29), pp. 2441–2443. Available at:
https://doi.org/10.1093/eurheartj/ehz263.
Shahjehan, R. and Bhutta, B. (2022) Coronary Artery Disease. StatPearls [Internet]. Treasure Island (FL): StatPearls.
Udell, J.A. et al. (2016) ‘Long-term dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: A collaborative meta-analysis of randomized trials’, European Heart Journal, 37(4), pp. 390–399. Available at:
https://doi.org/10.1093/eurheartj/ehv443.
Vranckx, P. et al. (2018) ‘Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-label, randomised superiority trial’, The Lancet, 392(10151), pp. 940–949. Available at:
https://doi.org/10.1016/S0140-6736(18)31858-0.
Watanabe, Hirotoshi et al. (2022) ‘Comparison of Clopidogrel Monotherapy after 1 to 2 Months of Dual Antiplatelet Therapy with 12 Months of Dual Antiplatelet Therapy in Patients with Acute Coronary Syndrome: The STOPDAPT-2 ACS Randomized Clinical Trial’, JAMA Cardiology, 7(4), pp. 407–417. Available at: https://doi.org/10.1001/jamacardio.2021.5244.
Wu, Y. et al. (2019) ‘High on-clopidogrel platelet reactivity and chronic kidney disease: a meta-analysis of literature studies’, Scandinavian Cardiovascular Journal, 53(2), pp. 55–61. Available at: https://doi.org/10.1080/14017431.2019.1598571.
Zhang, Y.J. et al. (2022) ‘Influence of genetic polymorphisms in P2Y12 receptor signaling pathway on antiplatelet response to clopidogrel in coronary heart disease’, BMC Cardiovascular Disorders, 22(1), pp. 1–11. Available at: https://doi.org/10.1186/s12872-022-02988-w.
DOI: http://dx.doi.org/10.52689/higea.v16i1.590
Refbacks
- Saat ini tidak ada refbacks.
##submission.license.cc.by-nc-sa4.footer##
