Duplice terapia antiaggregante di breve durata: come, quando e perché

Translated title of the contribution: Short dual antiplatelet therapy: how, when and why

Valentina Ditali, Chiara Carrozzi, Sergio Leonardi

Research output: Contribution to journalArticlepeer-review


Dual antiplatelet therapy (DAPT) is a cornerstone of antithrombotic treatment in patients undergoing percutaneous coronary intervention. The optimal duration of DAPT, i.e. the minimal period needed to ensure the best safety and efficacy, to prevent ischemic complications, including stent thrombosis, has been extensively explored in multiple randomized controlled trials over the last years. Accumulating evidence is supporting a clinical approach where there is a prevailing role of the risk of bleeding: in patients at high bleeding risk (HBR) it is generally advisable to reduce the duration of DAPT irrespective of their risk of thrombosis. In addition, among HBR patients, (i) new recommendations prefer direct oral anticoagulants (DOAC) over vitamin K antagonists in DOAC-eligible patients with atrial fibrillation and coronary artery disease; (ii) measures to minimize bleedings while on DAPT should be pursued, including de-escalation of P2Y12 receptor inhibitor therapy; and (iii) new studies are testing reversal strategies for short DAPT regimens, with early discontinuation of aspirin. In the present review, we discuss the rationale and decision-making considerations to reduce safely DAPT duration in HBR patients.

Translated title of the contributionShort dual antiplatelet therapy: how, when and why
Original languageItalian
Pages (from-to)14-25
Number of pages12
JournalGiornale italiano di cardiologia (2006)
Issue number2
Publication statusPublished - Feb 1 2020

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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