A New Era in Secondary Prevention after Acute Coronary Syndrome

During the past two decades, the use of antiplatelet therapies has been the focus of new studies of secondary prevention after acute coronary syndromes, with more than 75% of patients in contemporary practice treated with dual antiplatelet therapy (aspirin plus a thienopyridine) on hospital discharge.1 Despite increases in the use of antiplatelet therapies and the development of more potent antiplatelet therapies (prasugrel and ticagrelor), the residual risk of death, myocardial infarction, or stroke up to 1 year after acute coronary syndromes remains high2,3 (Table 1). This represents a therapeutic challenge, since the balance between risk (major bleeding) and benefit . . .