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October 1, 2017Open HeartOpen Access

Dual antiplatelet therapy for secondary prevention of coronary artery disease

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Why the study?

What is the optimal duration and regimen of dual antiplatelet therapy for secondary prevention in patients with coronary artery disease?

Population

Patients with coronary artery disease, including acute coronary syndrome or undergoing percutaneous coronary…

Comparison

Dual antiplatelet therapy combining aspirin and… vs Aspirin monotherapy or different durations of DAPT

Design

Review

Authors

SDSophie DegrauweTPThomas PilgrimAAAdel Aminian

Discussion

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Overview

May support risk-tailored DAPT over fixed durations; leaves open prospective validation of ischemic-bleeding trade-offs.

Key Points

  • This review aims to evaluate the effectiveness and safety of dual antiplatelet therapy durations for secondary prevention of coronary artery disease.
  • Review of randomized trials evaluating DAPT durations in patients with coronary artery disease
  • Assessment of major adverse cardiovascular events and bleeding risks based on different DAPT durations
  • Focus on patient management strategies and individual risk profiles.
  • Shorter DAPT durations (3-6 months) were non-inferior to longer durations (12-24 months) for major adverse cardiovascular events but reduced bleeding risk.
  • Longer DAPT durations (18-48 months) decreased myocardial infarction and stent thrombosis but increased bleeding and mortality risk.
  • Current guidelines suggest a 12-month DAPT duration for patients with acute coronary syndrome, pending results from ongoing trials.

Structured PICO

What is the optimal duration and regimen of dual antiplatelet therapy for secondary prevention in patients with coronary artery disease?

P
Population
Patients with coronary artery disease (CAD), including acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) for stable CAD
I
Intervention
Dual antiplatelet therapy (DAPT) combining aspirin and a P2Y12 receptor inhibitor
C
Comparator
Aspirin monotherapy or different durations of DAPT
O
Outcome
Major adverse cardiovascular events (MACE) and major bleeding

The optimal duration of DAPT for secondary prevention of CAD requires a tailored approach based on individual ischemic and bleeding risks.

Cite This Study

Degrauwe et al. (2017) studied this question.

synapsesocial.com/papers/69a5fa93019432c3a5736678https://doi.org/10.1136/openhrt-2017-000651
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