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Consensus Document ANMCO/ANCE/ARCA/GICR-IACPR/GISE/SICOA: Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease

Authors :
Gulizia, Michele Massimo
Colivicchi, Furio
Abrignani, Maurizio Giuseppe
Ambrosetti, Marco
Aspromonte, Nadia
Barile, Gabriella
Caporale, Roberto
Casolo, Giancarlo
Chiuini, Emilia
Di Lenarda, Andrea
Faggiano, Pompilio
Gabrielli, Domenico
Geraci, Giovanna
La Manna, Alessio Gaetano
Maggioni, Aldo Pietro
Marchese, Alfredo
Massari, Ferdinando Maria
Mureddu, Gian Francesco
Musumeci, Giuseppe
Nardi, Federico
Panno, Antonio Vittorio
Pedretti, Roberto Franco Enrico
Piredda, Massimo
Pusineri, Enrico
Riccio, Carmine
Rossini, Roberta
di Uccio, Fortunato Scotto
Urbinati, Stefano
Varbella, Ferdinando
Zito, Giovanni Battista
De Luca, Leonardo
Source :
European Heart Journal Supplements: Journal of the European Society of Cardiology; May 2018, Vol. 20 Issue: 1, Number 1 Supplement 6 pF1-F74, 74p
Publication Year :
2018

Abstract

Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12receptor inhibitor is the cornerstone of pharmacologic management of patients with acute coronary syndrome (ACS) and/or those receiving coronary stents. Long-term (>1 year) DAPT may further reduce the risk of stent thrombosis after a percutaneous coronary intervention (PCI) and may decrease the occurrence of non-stent-related ischaemic events in patients with ACS. Nevertheless, compared with aspirin alone, extended use of aspirin plus a P2Y12receptor inhibitor may increase the risk of bleeding events that have been strongly linked to adverse outcomes including recurrent ischaemia, repeat hospitalisation and death. In the past years, multiple randomised trials have been published comparing the duration of DAPT after PCI and in ACS patients, investigating either a shorter or prolonged DAPT regimen. Although the current European Society of Cardiology guidelines provide a backup to individualised treatment, it appears to be difficult to identify the ideal patient profile which could safely reduce or prolong the DAPT duration in daily clinical practice. The aim of this consensus document is to review contemporary literature on optimal DAPT duration, and to guide clinicians in tailoring antiplatelet strategies in patients undergoing PCI or presenting with ACS.

Details

Language :
English
ISSN :
1520765X and 15542815
Volume :
20
Issue :
1, Number 1 Supplement 6
Database :
Supplemental Index
Journal :
European Heart Journal Supplements: Journal of the European Society of Cardiology
Publication Type :
Periodical
Accession number :
ejs45837762
Full Text :
https://doi.org/10.1093/eurheartj/suy019