Key result
Post-PCI trends favor extended P2Y12 monotherapy and dropping aspirin after 3 months over standard DAPT.
Why the study?
Standard-duration DAPT post-PCI has been challenged regarding optimal duration and composition, with emerging regimens evaluating P2Y12 inhibitor monotherapy and restricted aspirin use.
Do newer antiplatelet regimens (such as P2Y12 inhibitor monotherapy) provide effective therapy in post-PCI patients compared to standard duration DAPT?
Do newer antiplatelet regimens (such as P2Y12 inhibitor monotherapy) provide effective therapy in post-PCI patients compared to standard duration DAPT?
There is an evolving trend toward using P2Y12 inhibitor monotherapy and restricting aspirin use beyond 3 months post-PCI, challenging traditional standard-duration DAPT guidelines.
May support shorter aspirin use post-PCI; hypothesis-generating and should not yet change practice.
The standard duration dual antiplatelet therapy (DAPT) is considered as gold standard for post percutaneous coronary intervention (PCI) medical therapy, as mentioned in American College of Cardiology/American Heart Association 2016 and European Society of Cardiology 2017 guidelines. Recently it has been challenged, in terms of duration and composition of this therapy. Many newer regimens and therapeutic drugs are being tried in large randomized clinical trial studies and found to be as effective as DAPT if not superior. There is general trend to introduce better antiplatelets like P2Y12 inhibitor (prasugrel and ticagrelor) as monotherapy for longer duration and restricting use of aspirin beyond 3 months. This review article helps us in understanding the evolution of DAPT therapy, formation of guidelines, and what are the new and evolving concepts in post-PCI medical therapy.
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Jadhav et al. (2020) conducted a review in Post percutaneous coronary intervention (PCI). P2Y12 inhibitor monotherapy vs. Standard duration dual antiplatelet therapy (DAPT) was evaluated. Recent trends in post-PCI medical therapy favor introducing P2Y12 inhibitor monotherapy for longer durations and restricting aspirin use beyond 3 months compared to standard DAPT.
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