Online first
Review Article
Published online: 2025-03-20
Early treatment with inhibitors of P2Y12 receptor in patients with ST-segment elevation myocardial infarction — 2023 ESC recommendations and scientific evidence. Is clinical evidence sufficient to suggest a move towards precision medicine? The ELECTRA-SIRIO 2 investigators’ viewpoint
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DOI: 10.5603/cj.99973
Pubmed: 40109248
Abstract
The 2023 ESC guidelines changed previously recommended a strategy of early treatment in patients with STEMI. Pre-treatment with a P2Y12 receptor inhibitor may be considered in patients undergoing a primary PCI strategy (Class IIb, Level of evidence B). However, the available scientific evidence justifies a personalized approach differentiating the indications for pre-treatment with oral P2Y12 receptor inhibitors depending on the concomitant administration of opioids. In our opinion, in patients undergoing primary PCI not treated with opioids, pre-treatment with an oral P2Y12 receptor inhibitor should be applied, while in patients undergoing primary PCI treated with opioids, pre-treatment with an oral P2Y12 receptor inhibitor should be considered.
Keywords: ACSSTEMIP2Y12pretreatmentESC guidelines
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