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

Research output: Contribution to journalArticle

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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Coronary Artery Disease
Acute Coronary Syndrome
Percutaneous Coronary Intervention
Aspirin
Therapeutics
Stents
Hospitalization
Thrombosis
Ischemia
Guidelines
Hemorrhage

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Consensus Document ANMCO/ANCE/ARCA/GICR-IACPR/GISE/SICOA : Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease. / Gulizia, Michele Massimo; Colivicchi, Furio; Abrignani, Maurizio Giuseppe; Ambrosetti, Marco; Aspromonte, Nadia; Barile, Gabriella; Caporale, Roberto; Casolo, Giancarlo; Chiuini, Emilia; Di Lenarda, Andrea; Faggiano, Pompilio; Gabrielli, Domenico; Geraci, Giovanna; La Manna, Alessio Gaetano; Maggioni, Aldo Pietro; Marchese, Alfredo; Massari, Ferdinando Maria; Mureddu, Gian Francesco; Musumeci, Giuseppe; Nardi, Federico; Panno, Antonio Vittorio; Pedretti, Roberto Franco Enrico; Piredda, Massimo; Pusineri, Enrico; Riccio, Carmine; Rossini, Roberta; di Uccio, Fortunato Scotto; Urbinati, Stefano; Varbella, Ferdinando; Zito, Giovanni Battista; De Luca, Leonardo.

In: European Heart Journal, Supplement, Vol. 20, No. Suppl F, 05.2018, p. F1-F74.

Research output: Contribution to journalArticle

Gulizia, MM, Colivicchi, F, Abrignani, MG, Ambrosetti, M, Aspromonte, N, Barile, G, Caporale, R, Casolo, G, Chiuini, E, Di Lenarda, A, Faggiano, P, Gabrielli, D, Geraci, G, La Manna, AG, Maggioni, AP, Marchese, A, Massari, FM, Mureddu, GF, Musumeci, G, Nardi, F, Panno, AV, Pedretti, RFE, Piredda, M, Pusineri, E, Riccio, C, Rossini, R, di Uccio, FS, Urbinati, S, Varbella, F, Zito, GB & 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, vol. 20, no. Suppl F, pp. F1-F74. https://doi.org/10.1093/eurheartj/suy019
Gulizia, Michele Massimo ; Colivicchi, Furio ; Abrignani, Maurizio Giuseppe ; Ambrosetti, Marco ; Aspromonte, Nadia ; Barile, Gabriella ; Caporale, Roberto ; Casolo, Giancarlo ; Chiuini, Emilia ; Di Lenarda, Andrea ; Faggiano, Pompilio ; Gabrielli, Domenico ; Geraci, Giovanna ; La Manna, Alessio Gaetano ; Maggioni, Aldo Pietro ; Marchese, Alfredo ; Massari, Ferdinando Maria ; Mureddu, Gian Francesco ; Musumeci, Giuseppe ; Nardi, Federico ; Panno, Antonio Vittorio ; Pedretti, Roberto Franco Enrico ; Piredda, Massimo ; Pusineri, Enrico ; Riccio, Carmine ; Rossini, Roberta ; di Uccio, Fortunato Scotto ; Urbinati, Stefano ; Varbella, Ferdinando ; Zito, Giovanni Battista ; De Luca, Leonardo. / Consensus Document ANMCO/ANCE/ARCA/GICR-IACPR/GISE/SICOA : Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease. In: European Heart Journal, Supplement. 2018 ; Vol. 20, No. Suppl F. pp. F1-F74.
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T2 - Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease

AU - Gulizia, Michele Massimo

AU - Colivicchi, Furio

AU - Abrignani, Maurizio Giuseppe

AU - Ambrosetti, Marco

AU - Aspromonte, Nadia

AU - Barile, Gabriella

AU - Caporale, Roberto

AU - Casolo, Giancarlo

AU - Chiuini, Emilia

AU - Di Lenarda, Andrea

AU - Faggiano, Pompilio

AU - Gabrielli, Domenico

AU - Geraci, Giovanna

AU - La Manna, Alessio Gaetano

AU - Maggioni, Aldo Pietro

AU - Marchese, Alfredo

AU - Massari, Ferdinando Maria

AU - Mureddu, Gian Francesco

AU - Musumeci, Giuseppe

AU - Nardi, Federico

AU - Panno, Antonio Vittorio

AU - Pedretti, Roberto Franco Enrico

AU - Piredda, Massimo

AU - Pusineri, Enrico

AU - Riccio, Carmine

AU - Rossini, Roberta

AU - di Uccio, Fortunato Scotto

AU - Urbinati, Stefano

AU - Varbella, Ferdinando

AU - Zito, Giovanni Battista

AU - De Luca, Leonardo

PY - 2018/5

Y1 - 2018/5

N2 - 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.

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DO - 10.1093/eurheartj/suy019

M3 - Article

C2 - 29867293

VL - 20

SP - F1-F74

JO - European Heart Journal, Supplement

JF - European Heart Journal, Supplement

SN - 1520-765X

IS - Suppl F

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