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August 17, 2020SHILAP Revista de lepidopterologíaOpen Access

Dual Antiplatelet Therapy in Coronary Artery Disease

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Why the study?

Does dual antiplatelet therapy with ticagrelor or prasugrel reduce recurrent ischemic events compared to clopidogrel in patients with acute coronary syndrome?

Population

Patients with acute coronary syndrome (ACS)

Comparison

Dual antiplatelet therapy with newer agents vs Clopidogrel

Design

Review

Authors

RSRaghav SharmaPKPrathap KumarSPS. P. Prashanth

Discussion

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Overview

Supports guideline-directed DAPT with ticagrelor/prasugrel in ACS; leaves open optimal duration and selection in lower-risk patients.

Key Points

  • To review the efficacy, comparative benefits, and optimal duration of dual antiplatelet therapy regimens in patients with acute coronary syndrome.
  • Evaluation of clinical evidence comparing newer P2Y12 inhibitors (ticagrelor and prasugrel) against clopidogrel across different management strategies.
  • Review of clinical guidelines and risk assessment tools, including the DAPT and PRECISE-DAPT scores, for personalizing treatment duration.
  • Ticagrelor and prasugrel demonstrate superior reduction in recurrent ischemic events compared to clopidogrel, with prasugrel showing benefit in percutaneous coronary intervention and ticagrelor showing benefit regardless of treatment strategy.
  • Current clinical guidelines recommend 1 year of dual antiplatelet therapy for all acute coronary syndrome patients, extending ticagrelor (60 mg) up to 3 years in high-risk individuals.
  • The DAPT and PRECISE-DAPT scoring systems assist clinicians in balancing ischemic recurrence against bleeding risks to guide the duration of therapy.

Structured PICO

Does dual antiplatelet therapy with ticagrelor or prasugrel reduce recurrent ischemic events compared to clopidogrel in patients with acute coronary syndrome?

P
Population
Patients with acute coronary syndrome (ACS)
I
Intervention
Dual antiplatelet therapy (DAPT) with newer agents (ticagrelor or prasugrel)
C
Comparator
Clopidogrel

This review summarizes current guidelines recommending DAPT for 1 year in ACS patients, with extended ticagrelor therapy for high-risk patients, guided by risk scores.

Cite This Study

Sharma et al. (2020) studied this question.

synapsesocial.com/papers/69d56fa375589c71d767d9fehttps://doi.org/10.1007/s40119-020-00197-0
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Strategies to Optimize Dual Antiplatelet Therapy After Coronary Artery Stenting in Acute Coronary Syndrome2016 · 13 citations
  2. 2Dual Antiplatelet Therapy: A Concise Review for Clinicians2023 · 46 citations
  3. 3Dual antiplatelet therapy after acute coronary syndromes: no time for a CHANGE2017 · 2 citations
  4. 4Dual antiplatelet therapy in coronary artery disease2018
  5. 5Oral antiplatelet therapy in acute coronary syndromes: update 20122012 · 10 citations