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DAPT Duration

Abstract

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State of the art: duration of dual antiplatelet therapy after percutaneous coronary intervention and coronary stent implantation – past, present and future perspectives A prospective, randomized, open-label trial of 6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction: Rationale and design of the Rationale and design of the comparison between a P2Y12 inhibitor monotherapy versus dual antiplatelet therapy in patients undergoing implantation of coronary drug-eluting stents (SMART-CHOICE): A prospective multicenter randomized trial One-year outcome of a prospective trial stopping dual antiplatelet therapy at 3 months after everolimus-eluting cobalt-chromium stent implantation: ShortT and OPtimal duration of Dual AntiPlatelet Therapy after everolimus-eluting cobalt-chromium stent (STOPDAPT) trial Inhibition of Platelet Aggregation After Coronary Stenting in Patients Receiving Oral Anticoagulation Six Versus 12 Months of Dual Antiplatelet Therapy After Implantation of Biodegradable Polymer Sirolimus-Eluting Stent: Randomized Substudy of the I-LOVE-IT 2 Trial A Genotype-Guided Strategy for Oral P2Y12 Inhibitors in Primary PCI Mortality Following Cardiovascular and Bleeding Events Occurring Beyond 1 Year After Coronary Stenting - A Secondary Analysis of the Dual Antiplatelet Therapy (DAPT) Study

Original Research2018 Jan 14;39(3):181-183.

JOURNAL:Eur Heart J. Article Link

Dual antiplatelet therapy: how, how long, and in which patients?

Lüscher TF. Keywords: Dual antiplatelet therapy

ABSTRACT


Thrombus formation is a crucial event in acute coronary syndromes, bypass occlusion, and stent thrombosis. In the coronary circulation, platelet activation is an initial event,while expression of tissue factor and subsequent activation of the coagulation cascade and invading white blood cells solidify the evolving clot, an event that often leads to vascular occlusion. Platelets are primarily activated by thromboxane and ADP via thromboxane and P2Y12 receptors on the platelet surface that eventually lead to the expression of the glycoprotein IIB/IIIA receptor that binds fibrin. Twenty-one years ago, the first randomized clinical trial established the superiority of dual antiplatelet therapy over anticoagulant therapy among patients undergoing percutaneous coronary intervention. Thus, dual antiplatelet therapy has become a crucial therapeutic intervention in patients with stable or acute coronary artery disease.