Feng Wen-Han, Hsieh I-Chang, Li Yi-Heng
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.
Department of Internal Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan.
Acta Cardiol Sin. 2021 Jan;37(1):1-8. doi: 10.6515/ACS.202101_37(1).20200806A.
Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor for 6-12 months is the current standard treatment for patients after percutaneous coronary intervention (PCI). However, the optimal DAPT duration is still under debate. A novel strategy with P2Y12 inhibitor monotherapy after PCI has been proposed recently. This strategy shortens the duration of DAPT to 1 to 3 months, followed by monotherapy with a P2Y12 inhibitor instead of aspirin. It has been tested in several clinical trials with promising results. In this article, we reviewed the relevant clinical trial data and the scientific rationale of P2Y12 inhibitor monotherapy with laboratory evidence of platelet inhibition. An early aspirin-free strategy with P2Y12 inhibitor monotherapy seems feasible in some of the patients after PCI.
阿司匹林联合P2Y12抑制剂进行6至12个月的双重抗血小板治疗（DAPT）是目前经皮冠状动脉介入治疗（PCI）术后患者的标准治疗方法。然而，最佳的DAPT疗程仍存在争议。最近有人提出了一种PCI术后使用P2Y12抑制剂单药治疗的新策略。该策略将DAPT疗程缩短至1至3个月，随后使用P2Y12抑制剂单药治疗而非阿司匹林。它已在多项临床试验中进行了测试，结果令人鼓舞。在本文中，我们回顾了相关临床试验数据以及P2Y12抑制剂单药治疗的科学依据，并提供了血小板抑制的实验室证据。在一些PCI术后患者中，采用P2Y12抑制剂单药治疗的早期无阿司匹林策略似乎是可行的。
