Which statement is true about the P2Y12 inhibitors used in ACS?

Which statement is true about the P2Y12 inhibitors used in ACS?

• A. They all inhibit platelet aggregation by antagonizing the P2Y12 receptor
• B. They all have identical onset of action
• C. They are all administered intravenously
• D. They cause no bleeding risk

Answer: (A)

P2Y12 inhibitors all reduce platelet aggregation by blocking the P2Y12 receptor on platelets, which ADP normally binds to in order to amplify activation and clot formation. Among the available drugs, clopidogrel and prasugrel are thienopyridines that require metabolic activation and bind irreversibly to the P2Y12 receptor, so their effect lasts for the life of the platelet. Ticagrelor, on the other hand, is a direct-acting, reversible P2Y12 receptor antagonist that does not require activation. Cangrelor is an intravenous, reversible inhibitor with immediate onset and rapid offset. Because of these differences, onset of action varies: rapid with cangrelor, and faster with ticagrelor than with clopidogrel; prasugrel and ticagrelor offer quicker action than clopidogrel but are not identical. It’s also important to note that these drugs do increase bleeding risk, rather than having no bleeding risk.

P2Y12 inhibitors all reduce platelet aggregation by blocking the P2Y12 receptor on platelets, which ADP normally binds to in order to amplify activation and clot formation. Among the available drugs, clopidogrel and prasugrel are thienopyridines that require metabolic activation and bind irreversibly to the P2Y12 receptor, so their effect lasts for the life of the platelet. Ticagrelor, on the other hand, is a direct-acting, reversible P2Y12 receptor antagonist that does not require activation. Cangrelor is an intravenous, reversible inhibitor with immediate onset and rapid offset. Because of these differences, onset of action varies: rapid with cangrelor, and faster with ticagrelor than with clopidogrel; prasugrel and ticagrelor offer quicker action than clopidogrel but are not identical. It’s also important to note that these drugs do increase bleeding risk, rather than having no bleeding risk.