Key result
Dual antiplatelet therapy was associated with greater adverse events, including unstable angina, mortality, and repeat revascularization, compared to single antiplatelet therapy in SCAD patients.
Why the study?
There is no clear consensus on the optimal antiplatelet regimen and duration for SCAD despite AHA recommendations for 12 months of DAPT following MI.
Does dual antiplatelet therapy (DAPT) improve safety and effectiveness compared to single antiplatelet therapy (SAPT) in patients with spontaneous coronary artery dissection (SCAD)?
Does dual antiplatelet therapy (DAPT) improve safety and effectiveness compared to single antiplatelet therapy (SAPT) in patients with spontaneous coronary artery dissection (SCAD)?
In patients with spontaneous coronary artery dissection, dual antiplatelet therapy is associated with higher rates of adverse events compared to single antiplatelet therapy.
Answers are grounded in this paper and cite their sources.
Should not yet change antiplatelet strategy in SCAD; leaves open need for randomized trials.
Background: Spontaneous coronary artery dissection (SCAD) is a poorly-studied cause of acute coronary syndrome (ACS), particularly in women. SCAD is a rare cause of ACS that can lead to myocardial injury due to SCAD. This review evaluates optimal antiplatelet therapy for SCAD patients. There is no clear consensus regarding the optimum antiplatelet medication regimen and treatment duration for SCAD despite current American Heart Association (AHA) consensus guidelines recommending 12-month regimen of dual antiplatelet therapy (DAPT) consisting of a P2Y12 inhibitor and aspirin for patients following myocardial infarction (MI). The objective of this study was to evaluate the safety and effectiveness of DAPT compared to using a single antiplatelet therapy (SAPT) as part of the medical armamentarium to treat SCAD. Methods: inhibitor) were administered. SCAD for SAPT and DAPT groups were analyzed by calculating the mean, standard deviation (SD), range, and 95% confidence intervals (CIs). Results were reported as mean ± SD, with CIs indicating precision. Studies lacking comprehensive data on concurrent cardiovascular medication use (e.g., beta-blockers, statins) or key outcome measures were excluded. Results: 2.33%). These adverse outcomes, primarily driven by increased non-fatal MI and unplanned percutaneous coronary interventions (PCIs), highlight the challenges of DAPT in SCAD management. Conclusions: In patients treated with antiplatelet therapy, adverse events that include unstable angina, mortality, and repeat revascularization were greater in patients with more aggressive antiplatelet therapy consisting for safety and efficacy of DAPT compared with these treated with SAPT.
No takes yet. Share an insight, caveat, or question.
Park et al. (2025) conducted a review in Spontaneous coronary artery dissection (SCAD). Dual antiplatelet therapy (DAPT) vs. Single antiplatelet therapy (SAPT) was evaluated on Adverse events including unstable angina, mortality, and repeat revascularization. Dual antiplatelet therapy was associated with greater adverse events, including unstable angina, mortality, and repeat revascularization, compared to single antiplatelet therapy in SCAD patients.
Synapse has enriched 10 related papers. Consider them for comparative context: