[ANMCO/ANCE/ARCA/GICR-IACPR intersociety consensus document: long-term antiplatelet therapy in patients with coronary artery disease]. in Giornale italiano di cardiologia (2006) / G Ital Cardiol (Rome). 2018 May;19(5):263-331. doi: 10.1714/2907.29280.
2018
ASL Torino 3
AO Cuneo
AOU Città della Salute di Torino
ASL Alessandria
Tipo pubblicazione
Practice Guideline
Autori/Collaboratori (31)Vedi tutti...
De Luca L
U.O.C. Cardiologia, Ospedale San Giovanni Evangelista, Tivoli (RM).
Zito GB
Ambulatorio di Cardiologia, ASL Napoli 3 Sud, Pompei (NA).
Urbinati S
U.O.C. Cardiologia, Ospedale Bellaria, AUSL di Bologna, Bologna.
et alii...
Abstract
Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor is the cornerstone of the pharmacologic management of patients with acute coronary syndrome (ACS) and/or receiving coronary stents. Long-term (>1 year) DAPT may further reduce the risk of stent thrombosis after percutaneous coronary intervention (PCI) and may decrease the occurrence of non-stent-related ischemic events in patients with ACS. Nevertheless, compared with aspirin alone, extended use of aspirin plus a P2Y12 receptor inhibitor may increase the risk of bleeding events that have been strongly linked to adverse outcomes including recurrent ischemia, repeat hospitalization, and death. Over the last years, multiple randomized clinical trials have been published comparing duration of DAPT after PCI and in ACS patients investigating either a shorter or prolonged DAPT regimen.Although current European Society of Cardiology guidelines provide backup to individualize treatment, it seems difficult to identify the ideal patient profile who could safely reduce or prolong DAPT duration in daily clinical practice. The aim of this consensus document is to review the contemporary literature on optimal DAPT duration and to guide clinicians in tailoring antiplatelet strategies in patients undergoing PCI or presenting with ACS.
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PMID : 29853716
DOI : 10.1714/2907.29280
Keywords
Time Factors; Stents; Randomized Controlled Trials as Topic; Purinergic P2Y Receptor Antagonists/administration & dosage/adverse effects; Humans; Percutaneous Coronary Intervention/methods; Platelet Aggregation Inhibitors/administration & dosage/adverse effects/pharmacology; Hemorrhage/chemically induced; Hospitalization/statistics & numerical data; Coronary Artery Disease/therapy; Drug Therapy, Combination; Aspirin/administration & dosage/adverse effects; Acute Coronary Syndrome/therapy;