Should P2Y12 inhibitors be given for 12 months in acute coronary syndrome?
作者信息
Christodoulidis Georgios, Baber Usman, Mehran Roxana
机构信息
aThe Icahn School of Medicine at Mount Sinai bCardiovascular Research Foundation, New York, NY, USA.
出版信息
Curr Opin Cardiol. 2014 Jul;29(4):301-6. doi: 10.1097/HCO.0000000000000070.
PURPOSE OF REVIEW
To provide updates regarding the optimal duration of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS).
RECENT FINDINGS
Within the past years, five moderate-sized randomized controlled trials evaluated different DAPT durations after percutaneous coronary intervention. These studies included a significant percentage of ACS patients that varied from 30 to 75% depending on the study. Results suggest that in selected populations prolonging DAPT does not offer additional protection from ischemic events and increases bleeding complications. However, results from a large-scale registry illustrate that DAPT durations beyond 6 months are associated with lower cardiovascular risk. Moreover, a multicenter registry demonstrated that the context underlying DAPT cessation is an additional correlate of outcomes after stent implantation.
SUMMARY
Current guidelines suggest 12 months of DAPT after an initial presentation with ACS. Emerging evidence suggest that in selected populations shorter duration might be acceptable.
Zotero 插件