Table 2:
Agent | Clopidogrela | Ticagrelor | Prasugrel |
---|---|---|---|
Loading doseb | 600 mg | 180 mg | 40–60 mg |
Maintenance dose | 75 mg daily | 60–90 mg 2×/day | 5–10 mg daily |
Trade name | Plavix | Brilinta/Brilique | Effient |
Onset of action | 2 hours | 30 min | 15–30 min |
The panel favored clopidogrel as the oral P2Y12 inhibitor of choice in the postprocedural period after discontinuation of the GPIIb/IIIa inhibitor but acknowledged that in case of known clopidogrel resistance, an alternative P2Y12 inhibitor may be chosen and that evidence from unruptured intracranial aneurysm treatment might suggest a superior safety profile of prasugrel compared with clopidogrel in the acute phase.28 It was thought that in cases in which ticagrelor was administered in the periprocedural period, it could be continued beyond the periprocedural period, depending on the cost and availability of different agents.
If deemed necessary.