Sumner Jacob D, Zinser Brianna, Smith Andrew
1 Research Medical Center, Kansas City, MO, USA.
2 School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA.
J Pharm Pract. 2018 Jun;31(3):335-341. doi: 10.1177/0897190017715560. Epub 2017 Jun 20.
To review the evidence on the safety and efficacy of the continued use of dual antiplatelet therapy (DAPT) beyond 12 months after stent placement in patients following an acute coronary syndrome (ACS) event.
Recently, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a focused update on the duration of DAPT in patients with coronary artery disease (CAD). The update makes new recommendations about the duration of DAPT in light of recently performed studies investigating this topic. In regard to patients after an ACS event, the update states it is reasonable to continue DAPT beyond 1 year if these patients are not at a high risk of bleeding and had no overt bleeding while on DAPT. Several trials have been released which aim to provide information about the correct duration of DAPT after an ACS event.
Recent trials have shown a benefit of prolonged (beyond 12 months) DAPT in preventing recurrent cardiovascular (CV) events in patients, mostly in patients who have had a previous myocardial infarction (MI). These benefits must be weighed with the elevated risks of bleeding.
