ACC/AHA guidelines: BRILINTA preferred over clopidogrel in ACS in 2016 ACC/AHA DAPT guideline1

According to the 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy (DAPT)

BRILINTA is preferred over clopidogrel in ACS (Class IIa; LOE B-R)

IN PATIENTS WITH STEMI who have received a coronary stent (Class IIa; LOE B-R)

IN PATIENTS WITH NSTE-ACS who have received a coronary stent or are managed with medical therapy alone (Class IIa; LOE B-R)

Class I recommendation (LOE B-R)

Use of dual antiplatelet therapy for at least 12 months in patients with ACS

BRILINTA as a treatment option in patients with ACS who undergo stent implantation or who are managed with medical therapy alone

Since 2014 update of the AHA/ACC NSTE-ACS guideline, BRILINTA has been preferred over clopidogrel for the management of NSTE-ACS2

Class IIa recommendation

Use of BRILINTA over clopidogrel in patients with NSTE-ACS with early invasive or ischemia-guided strategy or receiving a coronary stent (LOE-B)

Class I recommendation

BRILINTA as a treatment option in the management of patients with NSTE-ACS (LOE-B)

Class of recommendation and level of evidence

 

  • Class I recommends that the procedure/treatment should be performed/administered
  •  

  • Class IIa states that it is reasonable to perform procedure/administer treatment
  •  

  • Level B-R is moderate-quality evidence from 1 or more RCTs or meta-analyses of moderate-quality RCTs
  •  

  • Level B is based on data derived from a single randomized clinical trial or nonrandomized studies

ACC=American College of Cardiology; ACS=acute coronary syndrome; AHA=American Heart Association; LOE=level of evidence; NSTE-ACS=non–ST-elevation acute coronary syndrome; RCT=randomized controlled trial; STEMI=ST-elevation myocardial infarction.

References
  1. Levine GN, Bates ER, Bittl JA, et al. 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease. Circulation. 2016;134(10):e123-e155.
  2. Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: A report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;130:e344-e426.