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DAPT Duration

Abstract

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A risk score to predict postdischarge bleeding among acute coronary syndrome patients undergoing percutaneous coronary intervention: BRIC-ACS study Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting: a randomized multicenter trial Study of Two Dose Regimens of Ticagrelor Compared with Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention for Stable Coronary Artery Disease (STEEL-PCI) Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry Extended antiplatelet therapy with clopidogrel alone versus clopidogrel plus aspirin after completion of 9- to 12-month dual antiplatelet therapy for acute coronary syndrome patients with both high bleeding and ischemic risk. Rationale and design of the OPT-BIRISK double-blinded, placebo-controlled randomized trial The optimal duration of dual antiplatelet therapy after coronary stent implantation: to go too far is as bad as to fall short Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial Dual Antiplatelet Therapy Duration in Medically Managed Acute Coronary Syndrome Patients: Sub-Analysis of the OPT-CAD 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.