European Cardiology Review (Nov 2021)
2021 Asian Pacific Society of Cardiology Consensus Recommendations on the Use of P2Y12 Receptor Antagonists in the Asia-Pacific Region: Special Populations
- Jack Wei Chieh Tan,
- Derek P Chew,
- Kin Lam Tsui,
- Doreen Tan,
- Dmitry Duplyakov,
- Ayman Hammoudeh,
- Bo Zhang,
- Yi Li,
- Kai Xu,
- Paul J Ong,
- Doni Firman,
- Habib Gamra,
- Wael Almahmeed,
- Jamshed Dalal,
- Li-Wah Tam,
- Gabriel Steg,
- Quang N Nguyen,
- Junya Ako,
- Jassim Al Suwaidi,
- Mark Chan,
- Mohamed Sobhy,
- Abdulla Shehab,
- Wacin Buddhari,
- Zulu Wang,
- Alan Yean Yip Fong,
- Bilgehan Karadag,
- Byeong-Keuk Kim,
- Usman Baber,
- Chee Tang Chin,
- Ya Ling Han
Affiliations
- Jack Wei Chieh Tan
- National Heart Centre, Singapore; Sengkang General Hospital, Singapore
- Derek P Chew
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Kin Lam Tsui
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
- Doreen Tan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
- Dmitry Duplyakov
- Samara Regional Cardiology Dispensary, Samara, Russia
- Ayman Hammoudeh
- Cardiology Department, Istishari Hospital, Amman, Jordan
- Bo Zhang
- Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
- Yi Li
- Department of Cardiology, General Hospital of Northern Theatre Command, Shenyang, China
- Kai Xu
- Department of Cardiology, General Hospital of Shenyang Military, Shenyang, China
- Paul J Ong
- Heart Specialist International, Mount Elizabeth Novena Hospital, Singapore; Tan Tock Seng Hospital, Singapore
- Doni Firman
- Harapan Kita National Cardiovascular Center/Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia Harapan Kita, Jakarta, Indonesia
- Habib Gamra
- Cardiology Department, Fattouma Bourguiba University Hospital and University of Monastir, Monastir, Tunisia
- Wael Almahmeed
- Cleveland Clinic Abu Dhabi, United Arab Emirates
- Jamshed Dalal
- Centre for Cardiac Sciences, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
- Li-Wah Tam
- Kwong Wah Hospital, Hong Kong, China
- Gabriel Steg
- Department of Cardiology, Hôpital Bichat, Paris, France
- Quang N Nguyen
- Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
- Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
- Jassim Al Suwaidi
- Adult Cardiology, Hamad Medical Corporation, Doha, Qatar
- Mark Chan
- National University Heart Centre, Singapore
- Mohamed Sobhy
- Faculty of Medicine, Alexandria University, Egypt
- Abdulla Shehab
- College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
- Wacin Buddhari
- King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Zulu Wang
- Department of Cardiology, General Hospital of Shenyang Military, Shenyang, China
- Alan Yean Yip Fong
- Sarawak Heart Centre, Kota Samarahan, Malaysia
- Bilgehan Karadag
- Istanbul University-Cerrahpasa School of Medicine, Istanbul, Turkey
- Byeong-Keuk Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Usman Baber
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, US
- Chee Tang Chin
- National Heart Centre, Singapore
- Ya Ling Han
- Department of Cardiology, General Hospital of Northern Theatre Command, Shenyang, China
- DOI
- https://doi.org/10.15420/ecr.2021.35
- Journal volume & issue
-
Vol. 16
Abstract
Advanced age, diabetes, and chronic kidney disease not only increase the risk for ischaemic events in chronic coronary syndromes (CCS) but also confer a high bleeding risk during antiplatelet therapy. These special populations may warrant modification of therapy, especially among Asians, who have displayed characteristics that are clinically distinct from Western patients. Previous guidance has been provided regarding the classification of high-risk CCS and the use of newer-generation P2Y12 inhibitors (i.e. ticagrelor and prasugrel) after acute coronary syndromes (ACS) in Asia. The authors summarise evidence on the use of these P2Y12 inhibitors during the transition from ACS to CCS and among special populations. Specifically, they present recommendations on the roles of standard dual antiplatelet therapy, shortened dual antiplatelet therapy and single antiplatelet therapy among patients with coronary artery disease, who are either transitioning from ACS to CCS; elderly; or with chronic kidney disease, diabetes, multivessel coronary artery disease and bleeding events during therapy.
