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Intravenous P2Y12 Inhibitors in Patients Undergoing PCI
COR LOE
Recommendation
2b B-R 1. In patients undergoing PCI who are P2Y12 inhibitor
naïve, intravenous cangrelor may be reasonable to reduce
periprocedural ischemic events.
Intravenous Glycoprotein IIb/IIIa Inhibitors in Patients
Undergoing PCI
COR LOE
Recommendations
2a C-LD 1. In patients with ACS undergoing PCI with large thrombus
burden, no-reflow, or slow flow, intravenous glycoprotein IIb/
IIIa inhibitor agents are reasonable to improve procedural
success.
3: No
benefit
B-R 2. In patients with SIHD undergoing PCI, the routine use of
an intravenous glycoprotein IIb/IIIa inhibitor agent is NOT
recommended.
Heparin, Low-Molecular-Weight Heparin, and Bivalirudin in
Patients Undergoing PCI
COR LOE
Recommendations
1 C-EO 1. In patients undergoing PCI, administration of intravenous
UFH is useful to reduce ischemic events.
1 C-LD 2. In patients with heparin-induced thrombocytopenia
undergoing PCI, bivalirudin or argatroban should be used to
replace UFH to avoid thrombotic complications.
2b A 3. In patients undergoing PCI, bivalirudin may be a reasonable
alternative to UFH to reduce bleeding.
2b B-R 4. In patients treated with upstream subcutaneous enoxaparin
for unstable angina or NSTE-ACS, the use of intravenous
enoxaparin may be considered at the time of PCI to reduce
ischemic events.
3: Harm B-R 5. In patients on therapeutic subcutaneous enoxaparin, in whom
the last dose was administered within 12 hours of PCI, UFH
should NOT be used for PCI and may increase bleeding.
