Key result
Extended antithrombotics lower ischemic risk after complex PCI but increase bleeding complications.
Why the study?
Deciding the optimal type and duration of antithrombotic therapy in complex PCI is challenging because the ischemic benefits of prolonged or more potent regimens are counterbalanced by increased bleeding.
Does extended antithrombotic therapy reduce ischemic complications without excessive bleeding in patients undergoing complex percutaneous coronary intervention?
Does extended antithrombotic therapy reduce ischemic complications without excessive bleeding in patients undergoing complex percutaneous coronary intervention?
Tailored extended antithrombotic strategies, such as ticagrelor monotherapy following a short course of DAPT, offer a promising balance between mitigating high ischemic risk and minimizing bleeding in complex PCI patients.
Answers are grounded in this paper and cite their sources.
Reinforces known ischemic-bleeding trade-offs in complex PCI; leaves optimal regimen and duration open for dedicated RCTs.
Patients undergoing complex percutaneous coronary intervention (PCI) are at an increased risk of atherothrombotic complications. Although dual antiplatelet therapy is the mainstay of treatment for patients undergoing PCI with stent implantation, deciding its type and duration in complex PCI patients has long been considered a challenge for clinicians. This is because the beneficial effects of prolonged treatment and/or more potent antiplatelet agents' use in preventing ischemic events are hindered by a concomitant increase in bleeding complications. The aim of this review is to highlight current evidence regarding the optimal antithrombotic therapy regimens used in complex PCI patients, focusing on the evaluation of both safety and efficacy outcomes as well as addressing future perspectives.
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Benetou et al. (2021) conducted a review in Complex percutaneous coronary intervention. Extended antithrombotic therapy (prolonged DAPT, potent P2Y12 monotherapy, or rivaroxaban) vs. Standard short-term antithrombotic therapy was evaluated.
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