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

Michele Massimo Gulizia, Furio Colivicchi, Maurizio Giuseppe Abrignani, Marco Ambrosetti, Nadia Aspromonte, Gabriella Barile, Roberto Caporale, Giancarlo Casolo, Emilia Chiuini, Andrea Di Lenarda, Pompilio Faggiano, Domenico Gabrielli, Giovanna Geraci, Alessio Gaetano La Manna, Aldo Pietro Maggioni, Alfredo Marchese, Ferdinando Maria Massari, Gian Francesco Mureddu, Giuseppe Musumeci, Federico NardiAntonio Vittorio Panno, Roberto Franco Enrico Pedretti, Massimo Piredda, Enrico Pusineri, Carmine Riccio, Roberta Rossini, Fortunato Scotto di Uccio, Stefano Urbinati, Ferdinando Varbella, Giovanni Battista Zito, Leonardo De Luca

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Abstract

Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor 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 P2Y12 receptor 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.

Original languageEnglish
Pages (from-to)F1-F74
JournalEuropean Heart Journal, Supplement
Volume20
Issue numberSuppl F
DOIs
Publication statusPublished - May 2018

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Gulizia, M. M., Colivicchi, F., Abrignani, M. G., Ambrosetti, M., Aspromonte, N., Barile, G., Caporale, R., Casolo, G., Chiuini, E., Di Lenarda, A., Faggiano, P., Gabrielli, D., Geraci, G., La Manna, A. G., Maggioni, A. P., Marchese, A., Massari, F. M., Mureddu, G. F., Musumeci, G., ... De Luca, L. (2018). Consensus Document ANMCO/ANCE/ARCA/GICR-IACPR/GISE/SICOA: Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease. European Heart Journal, Supplement, 20(Suppl F), F1-F74. https://doi.org/10.1093/eurheartj/suy019