Christoph B. Olivier: New DGK Consensus Recommendations on Switching Antiplatelet Therapies
Christoph B. Olivier, Head of the Clinical Trials Unit, UHZ Freiburg, shared on LinkedIn about a recent article he and his colleagues co-authored, published in Die Kardiologie:
‘‘New official recommendations for switching antiplatelet therapies
Individualizing antithrombotic treatment is essential to balance ischemic and bleeding risks in patients with acute coronary syndrome (ACS) or those undergoing PCI.
However, transitioning between different P2Y12 inhibitors—both oral and intravenous—often raises critical clinical questions due to complex drug interactions and a lack of large-scale trial data.
Our latest consensus ‘Switching Antiplatelet Therapy: Interactions and Practical Guidance – Recommendations of the German Cardiac Society (DGK)‘, published in Die Kardiologie establishes clear, practical pathways for clinical routine:
- Escalation from Clopidogrel to Ticagrelor/Prasugrel: A direct switch is recommended.
- De-escalation to Clopidogrel: Routine de-escalation is strictly discouraged during the critical first 30 days post-ACS.
- Transitioning from Intravenous Cangrelor to oral therapy: Precise timing is critical to prevent gaps in platelet inhibition.
- Preoperative ‘Bridging’ Strategies: For urgent surgeries, intravenous Cangrelor offers the strongest evidence to safely bridge the cessation of oral therapy.
Coordinated alongside Dr. Diona Gjermeni this comprehensive guidance was developed by the German Cardiac Society (DGK) Commission for Clinical Practical Guidelines in close cooperation with the AG 19 – Cardiovascular Hemostasis and Antithrombotic Therapy, the Working Group on Clinical Pharmacology (AG 22), and the Working Group on Interventional Cardiology (AG 6) – AGIK – Interventional Cardiology.
I would also like to thank the hard work and dedication of the co-authors: Tobias Geisler, Karin Anne L. Müller, Dietmar Trenk, Tobias Petzold, Julinda Mehilli, Bernhard Rauch, Tanja Rudolph, Sven Waßmann, Willibald Hochholzer.”
Title: Conversion of antithrombocytic therapies: interactions and practical implementation – DGK recommendation
Authors: 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
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