TY - JOUR
T1 - Long-term dual antiplatelet therapy
T2 - Pharmacological and clinical implications
AU - Di Mario, Carlo
AU - Mugelli, Alessandro
AU - Perrone Filardi, Pasquale
AU - Rosano, Giuseppe
AU - Rossi, Francesco
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Patients experiencing an acute coronary syndrome are exposed to an increased residual risk of recurrent coronary events. Dual antiplatelet therapy (DAPT) is highly effective in preventing atherothrombotic complications in patients with previous myocardial infarction and current guidelines recommend the prescription of DAPT for at least 12 months in all patients experiencing an acute event. However, recent findings demonstrated that long-term DAPT (over 12 months) is related to a better outcome in patients at high risk, suggesting the use of a long-term DAPT to achieve a better clinical outcome. The choice of DAPT duration is still a difficult issue and a personalized approach to the patients is mandatory to manage both the residual ischemic risk and the risk of bleeding events. The aim of this review is to analyze the pharmacological characteristics of available antiplatelet agents and to revise the use of DAPT in clinical practice, focusing on the benefits of a long-term approach.
AB - Patients experiencing an acute coronary syndrome are exposed to an increased residual risk of recurrent coronary events. Dual antiplatelet therapy (DAPT) is highly effective in preventing atherothrombotic complications in patients with previous myocardial infarction and current guidelines recommend the prescription of DAPT for at least 12 months in all patients experiencing an acute event. However, recent findings demonstrated that long-term DAPT (over 12 months) is related to a better outcome in patients at high risk, suggesting the use of a long-term DAPT to achieve a better clinical outcome. The choice of DAPT duration is still a difficult issue and a personalized approach to the patients is mandatory to manage both the residual ischemic risk and the risk of bleeding events. The aim of this review is to analyze the pharmacological characteristics of available antiplatelet agents and to revise the use of DAPT in clinical practice, focusing on the benefits of a long-term approach.
KW - acute coronary syndrome
KW - cardiovascular risk
KW - coronary artery disease
KW - dual antiplatelet therapy
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U2 - 10.2459/JCM.0000000000000677
DO - 10.2459/JCM.0000000000000677
M3 - Review article
C2 - 29894353
AN - SCOPUS:85050126708
VL - 19
SP - 399
EP - 410
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 8
ER -