De uca L

[ANMCO/SICI-GISE document on antiplatelet therapy in patients with acute coronary syndrome].

Antiplatelet therapy is the cornerstone of the pharmacologic management of patients with acute coronary syndrome (ACS). Over the last years, several studies have evaluated old and new oral or intravenous antiplatelet agents in ACS patients. In particular, research was focused on assessing superiority of two novel platelet ADP P2Y12 receptor antagonists (i.e., prasugrel and ticagrelor) over clopidogrel. Several large randomized controlled trials have been undertaken in this setting and a wide variety of prespecified and post-hoc analyses are available that evaluated the potential benefits of novel antiplatelet therapies in different subsets of patients with ACS. The aim of this document is to review recent data on the use of current antiplatelet agents for in-hospital treatment of ACS patients. For each drug or class of drugs, strong evidence and/or areas of uncertainty that warrant further research are highlighted by examining 10 subgroups of patients with ACS.Leonardo De Luca1, Leonardo Bolognese2, Marco Valgimigli3, Roberto Ceravolo4, Gian Battista Danzi5, Emanuela Piccaluga6, Serena Rakar7, Alberto Cremonesi8, Francesco Maria Bovenzi9, a nome del Gruppo di Lavoro dell’Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) e della Società Italiana di Cardiologia Invasiva (SICI-GISE) (vedi Appendice) 1Dipartimento di Scienze Cardiovascolari, European Hospital, Roma 2Dipartimento Cardiovascolare e Neurologico, Ospedale San Donato, Arezzo 3Thoraxcenter, Erasmus MC, Rotterdam, Olanda 4U.O. di Emodinamica e Cardiologia Interventistica, Ospedale Pugliese-Ciaccio, Catanzaro 5Divisione di Cardiologia, Ospedale Santa Corona, Pietra Ligure (SV) 6Divisione di Cardiologia, Ospedale L. Sacco, Milano 7Divisione di Cardiologia, Ospedale Cattinara Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Trieste 8Dipartimento Cardiovascolare, GVM Care and Research, Maria Cecilia Hospital, Cotignola (RA) 9Dipartimento Cardio-Respiratorio, Ospedale Campo di Marte, Lucca