Optimal duration of dual antiplatelet therapy after acute coronary syndromes and coronary stenting

Learning objectives To provide an overview on the concept of dual antiplatelet therapy (DAPT). To review the evidence regarding shorter and longer DAPT duration. To describe the benefits and risks associated with shorter or longer duration of DAPT in patients with acute coronary syndrome and in patients with stable coronary artery disease after coronary stenting. To suggest an algorithm for optimal duration of DAPT. Introduction Dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 receptor antagonist (either a thienopyridine (clopidogrel or prasugrel) or a cyclopentyl-triazolopyrimidine (ticagrelor)) is the cornerstone of antithrombotic treatment after an acute coronary syndrome (ACS) and after coronary stenting. Treatment with DAPT after stent implantation reduces both stent thrombosis (ST) and cardiac ischaemic events that are caused by coronary lesions outside the stented segment, albeit at the cost of an increased risk of bleeding. The optimal duration of...
Source: Heart - Category: Cardiology Authors: Tags: Education in Heart, Drugs: cardiovascular system, Interventional cardiology, Venous thromboembolism, Clinical diagnostic tests Acute coronary syndromes, chronic ischaemic heart disease Source Type: research