Omitting aspirin in PCI patients: Myth or reality?

AbstractIn the current era of percutaneous coronary intervention (PCI), with the use of contemporary drug-eluting stents, refined techniques, and adjunctive pharmacotherapy, the role of aspirin peri-PCI remains undisputable. Beyond the initial period, dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 receptor inhibitor for 6 months in stable coronary artery disease and 12 months in acute coronary syndromes is the standard of care. However, concerns regarding bleeding adverse events caused by aspirin have led to shortened DAPT duration or even omission of aspirin. Aspirin free-strategies have been increasingly encountered in several studies and showed a significant reduction in bleeding events, without any sign of increased ischemic risk. Individualization of DAPT duration particularly in high bleeding risk patients appears therefore mandatory, making aspirin not necessary in several cases. Moreover, recent randomized trials have shed light on how to treat PCI patients in the presence of concomitant anticoagulant treatment with P2Y12 monotherapy and excluding aspirin. These aspirin-free strategies have been proved safer than the “older” standard triple antithrombotic treatment, without compromising safety. Ongoing studies may further dispel the myths and establish real facts regarding post-PCI-tailored treatment with or without aspirin.
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research

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Publication date: Available online 22 January 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Giuseppe De Luca, Monica Verdoia, Stefano Savonitto, Luca A. Ferri, Luigi Piatti, Daniele Grosseto, Nuccia Morici, Irene Bossi, Paolo Sganzerla, Giovanni Tortorella, Michele Cacucci, Maurizio Ferrario, Ernesto Murena, Girolamo Sibilio, Stefano Tondi, Anna Toso, Sergio Bongioanni, Amelia Ravera, Elena Corrada, Matteo MarianiAbstractBackgroundElderly patients are at increased risk of hemorrhagic and thrombotic complications after an acute coronary syndrome (ACS). Frailty, comorbilities and low body weight hav...
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
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Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
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Source: Atherosclerosis - Category: Cardiology Authors: Source Type: research
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Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
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Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
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Source: American Heart Journal - Category: Cardiology Source Type: research
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Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
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Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
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Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
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