Why the study?
While 12 months of DAPT remains the gold standard after acute coronary syndrome, recurrent ischemic events occur beyond 12 months and more potent agents raise bleeding concerns, making ischemic and bleeding risk balance central.
What is the optimal duration of dual antiplatelet therapy post percutaneous coronary intervention in acute coronary syndrome?
What is the optimal duration of dual antiplatelet therapy post percutaneous coronary intervention in acute coronary syndrome?
The review highlights the need to individualize DAPT duration post-PCI for ACS to optimally balance ischemic recurrence and bleeding risks.
Individualizing DAPT duration post-ACS balances ischemic and bleeding risks; review leaves open precise thresholds for prospective validation.
Dual antiplatelet therapy (DAPT), with aspirin plus a P2Y12 inhibitor agent, is the cornerstone treatment after percutaneous coronary intervention for acute coronary syndrome. Based on randomized clinical trial using aspirin and clopidogrel, a DAPT duration of 12 months has been recommended after an acute coronary syndrome. Despite the development of more potent antiplatelet agents (i.e. prasugrel and ticagrelor) and the reduction in ischemic recurrences after acute coronary syndrome, 12 months DAPT currently remains the gold standard. However, a significant proportion of patients experience recurrent ischemic events beyond the first 12 months after an acute coronary syndrome. Meanwhile, with more effective antiplatelet agent, bleeding has become a major safety concern on DAPT. Therefore, the ischemic and bleeding risk balance is central considering the duration of DAPT after an acute coronary syndrome. This review aims to report the evidence for an optimization and individualization of DAPT duration after an acute coronary syndrome.
No takes yet. Share an insight, caveat, or question.
Deharo et al. (2019) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: