Why the study?
To reduce bleeding events from prolonged DAPT and potent P2Y12 inhibitors, recent studies have explored P2Y12 inhibitor monotherapy after 1-3 months of DAPT in ACS.
Does P2Y12 inhibitor monotherapy after short-term DAPT reduce bleeding without increasing ischemic risk in patients with ACS treated with DES?
Does P2Y12 inhibitor monotherapy after short-term DAPT reduce bleeding without increasing ischemic risk in patients with ACS treated with DES?
P2Y12 inhibitor monotherapy after 1-3 months of DAPT is an effective de-escalation strategy that reduces bleeding risk without compromising ischemic protection in ACS patients undergoing PCI.
Dual antiplatelet therapy (DAPT), consisting of aspirin and a P2Y12inhibitor, has been the principal antiplatelet therapy after drug-eluting stent (DES) implantation in patients with acute coronary syndrome (ACS) and chronic coronary disease. Particularly in patients with ACS, which presents a higher ischemic risk than chronic coronary artery disease, DAPT for up to 12 months is the recommended standard treatment. However, to decrease bleeding events related to the potency of P2Y12inhibitors and a prolonged duration of DAPT, recent studies have suggested P2Y12inhibitor monotherapy after short-term DAPT (1–3 months), which decreased the bleeding risk without an increased ischemic risk. In this article, we discuss the evidence related to the efficacy of a P2Y12inhibitor as single-antiplatelet therapy after short-term DAPT compared with standard DAPT, with a focus on patients with ACS treated with DES.
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Hong et al. (2023) studied this question.
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