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DAPT Duration

Abstract

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P2Y12 Inhibitor Monotherapy with Clopidogrel Versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention Acute Coronary Syndrome, Antiplatelet Therapy, and Bleeding: A Clinical Perspective 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 Ticagrelor vs Clopidogrel After Fibrinolytic Therapy in Patients With ST-Elevation Myocardial Infarction: A Randomized Clinical Trial Trial Design Principles for Patients at High Bleeding Risk Undergoing PCI: JACC Scientific Expert Panel Major Bleeding Rates in Atrial Fibrillation Patients on Single, Dual, or Triple Antithrombotic Therapy Patient Selection and Clinical Outcomes in the STOPDAPT-2 Trial: An All-Comer Single-Center Registry During the Enrollment Period of the STOPDAPT-2 Randomized Controlled Trial Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry

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.