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<p>Antithrombotic therapy plays a&#xa0;central role in the prevention and treatment of thromboembolic events. Individual tailoring of therapy is often necessary to address patients’ specific needs and to minimize risks. In this context, it is essential to consider various clinical factors, such as age, the presence of comorbidities and concomitant medications. In addition to acetylsalicylic acid (ASA), commonly used treatment options include oral and intravenous P2Y12 inhibitors. Indications for de-escalation or escalation of antiplatelet therapy consider various aspects such as: adverse drug reactions, presence of contraindications to standard therapy and an increased risk of ischemic or bleeding events. Furthermore, changes in antithrombotic therapy may be required when treatment must be interrupted due to a&#xa0;surgical procedure or another intervention. Careful risk assessments and considerations of the pharmacokinetic and pharmacodynamic properties of the respective agents are necessary to determine the optimal therapeutic strategy and to avoid complications. This recommendation summarizes the pharmacological interactions and provides practical guidance on switching antithrombotic therapy.</p>

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Umstellung antithrombozytärer Therapien: Interaktionen und praktische Durchführung – DGK-Empfehlung

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月3日

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  • Diona Gjermeni,
  • Tobias Geisler,
  • Karin Anne L. Müller,
  • Dietmar Trenk,
  • Tobias Petzold,
  • Julinda Mehilli,
  • Bernhard H. Rauch,
  • Tanja Katharina Rudolph,
  • Sven Waßmann,
  • Willibald Hochholzer,
  • Christoph B. Olivier

摘要

Antithrombotic therapy plays a central role in the prevention and treatment of thromboembolic events. Individual tailoring of therapy is often necessary to address patients’ specific needs and to minimize risks. In this context, it is essential to consider various clinical factors, such as age, the presence of comorbidities and concomitant medications. In addition to acetylsalicylic acid (ASA), commonly used treatment options include oral and intravenous P2Y12 inhibitors. Indications for de-escalation or escalation of antiplatelet therapy consider various aspects such as: adverse drug reactions, presence of contraindications to standard therapy and an increased risk of ischemic or bleeding events. Furthermore, changes in antithrombotic therapy may be required when treatment must be interrupted due to a surgical procedure or another intervention. Careful risk assessments and considerations of the pharmacokinetic and pharmacodynamic properties of the respective agents are necessary to determine the optimal therapeutic strategy and to avoid complications. This recommendation summarizes the pharmacological interactions and provides practical guidance on switching antithrombotic therapy.