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

M.M. Gulizia, F. Colivicchi, M.G. Abrignani, M. Ambrosetti, N. Aspromonte, G. Barile, R. Caporale, G. Casolo, E. Chiuini, A. Di Lenarda, P. Faggiano, D. Gabrielli, G. Geraci, A.G. La Manna, A.P. Maggioni, A. Marchese, F.M. Massari, G.F. Mureddu, G. Musumeci, F. NardiA.V. Panno, R.F.E. Pedretti, M. Piredda, E. Pusineri, C. Riccio, R. Rossini, F.S. Di Uccio, S. Urbinati, F. Varbella, G.B. Zito, L. De Luca

Research output: Contribution to journalArticlepeer-review

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. © The Author(s) 2018.
Original languageEnglish
Pages (from-to)F1-F74
JournalEuropean Heart Journal, Supplement
Volume20
DOIs
Publication statusPublished - 2018

Keywords

  • acetylsalicylic acid
  • anticoagulant agent
  • antithrombocytic agent
  • purinergic P2Y receptor antagonist, acute coronary syndrome
  • Article
  • bleeding
  • cardiovascular risk
  • consensus development
  • coronary artery disease
  • diabetic patient
  • drug bioavailability
  • dual antiplatelet therapy
  • evidence based practice
  • frail elderly
  • health care management
  • heart infarction
  • heart muscle ischemia
  • heart muscle revascularization
  • human
  • Italy
  • kidney disease
  • long term care
  • medication compliance
  • patient assessment
  • percutaneous coronary intervention
  • peripheral occlusive artery disease
  • practice guideline
  • preoperative evaluation
  • priority journal
  • risk assessment
  • risk reduction
  • ST segment elevation
  • stable angina pectoris
  • stent thrombosis
  • therapy effect
  • thrombosis
  • treatment duration

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