Kardiologiya
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The analysis of the evidence that formed the basis for the current guidelines of the European Society of Cardiology (ESC) on oral therapy by antithrombotic drugs for acute coronary syndromes (ACS), and a comparison with the U. S. guidelines. The ESC guidelines, published during 2011-2012, declared the superiority of prasugrel and ticagrelor over clopidogrel in patients with ACS without ST elevation and myocardial infarction (MI) with ST elevation. ⋯ In contrast, the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines, published in 2012-2013, are more balanced, conservative and present evidence-based outlook, suggesting no proven extra benefit of one P2Y12 antagonist over the other(s). The ESC guidelines regarding the findings of the superiority of prasugrel or ticagrelor over clopidogrel are overly optimistic and not always evidence-based. A small frequency of clinical use of prasugrel and ticagrelor in the world in general and Europe in particular, suggests a discrepancy between the traditionally appointed treatment and published ESC guidelines.