Administration Timing of Antiplatelet Therapy is Changing

Physicians are administering antiplatelet therapy more during or after percutaneous coronary intervention than prior to the procedure.

A recent study found that physicians are changing their practices after a patient has a heart attack and administering antiplatelet therapy during or after a coronary artery procedure.

According to the study, presented at the European Association of Percutaneous Cardiovascular Interventions conference, administering antiplatelet agents such as P2Y12 inhibitors prior to the procedure is becoming less common.

Included in the study were 74,053 patients undergoing percutaneous coronary intervention (PCI) between January 2013 and June 2015. Data was gathered from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium.

There were no differences among in-hospital outcomes between patients receiving P2Y12 inhibitor therapy before their procedure compared with patients who were not treated with the therapy, according to the study. Over a 30-month period, researchers found that the administration of P2Y12 inhibitors before the procedure decreased from 49.3% to 24.8%.

Researchers found that more physicians are administering the therapy during or after the procedures, and the patients remained protected from stent thrombosis, bleeding, a need for a blood transfusion, and death, according to the study. The administration of P2Y12 inhibitors during or after the procedure increased from 48.8% in 2013 to 71.4% in 2015.

The researchers said the optimal timing for the drugs relative to PCI is a topic of debate.

"While more work is needed to determine the optimal timing in patients undergoing PCI, the current approach of increasingly reserving the use of these drugs after the patient enters the cath lab appears to be as effective and safe as pre-procedural administration," said Hitinder Gurm, MD, who leads the Blue Cross Blue Shield of Michigan Cardiovascular Consortium.