Dual Antiplatelet Therapy: A Concise Review for Clinicians
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Virk, Hafeez Ul Hassan, et al. Dual Antiplatelet Therapy: A Concise Review for Clinicians. MDPI, 2023. https://doi.org/10.17615/f0b9-5590APA
Virk, H., Escobar, J., Rodriguez, M., Bates, E., Khalid, U., Jneid, H., Birnbaum, Y., Levine, G., Smith, S., & Krittanawong, C. (2023). Dual Antiplatelet Therapy: A Concise Review for Clinicians. MDPI. https://doi.org/10.17615/f0b9-5590Chicago
Virk, Hafeez Ul Hassan, Johao Escobar, Mario Rodriguez, Eric R Bates, Umair Khalid, Hani Jneid, Yochai Birnbaum et al. 2023. Dual Antiplatelet Therapy: A Concise Review for Clinicians. MDPI. https://doi.org/10.17615/f0b9-5590- Creator
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Virk, Hafeez Ul Hassan
- Other Affiliation: Case Western Reserve University
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Escobar, Johao
- Other Affiliation: American College of Physicians
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Rodriguez, Mario
- Other Affiliation: Washington University, St. Louis School of Medicine
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Bates, Eric R.
- Other Affiliation: University of Michigan
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Khalid, Umair
- Other Affiliation: Baylor College of Medicine
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Jneid, Hani
- Other Affiliation: University of Texas Medical Branch
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Birnbaum, Yochai
- Other Affiliation: Baylor College of Medicine
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Levine, Glenn N.
- Other Affiliation: Baylor College of Medicine
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Smith, Sidney C.
- Affiliation: School of Medicine, Division of Cardiology, Department of Medicine
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Krittanawong, Chayakrit
- Other Affiliation: NYU School of Medicine
- Abstract
- Dual antiplatelet therapy (DAPT) combines two antiplatelet agents to decrease the risk of thrombotic complications associated with atherosclerotic cardiovascular diseases. Emerging data about the duration of DAPT is being published continuously. New approaches are trying to balance the time, benefits, and risks for patients taking DAPT for established cardiovascular diseases. Short-term dual DAPT of 3–6 months, or even 1 month in high-bleeding risk patients, is equivalent in terms of efficacy and effectiveness compared to long-term DAPT for patients who experienced percutaneous coronary intervention in an acute coronary syndrome setting. Prolonged DAPT beyond 12 months reduces stent thrombosis, major adverse cardiovascular events, and myocardial infarction rates but increases bleeding risk. Extended DAPT does not significantly benefit stable coronary artery disease patients in reducing stroke, myocardial infarction, or cardiovascular death. Ticagrelor and aspirin reduce cardiovascular events in stable coronary artery disease with diabetes but carry a higher bleeding risk. Antiplatelet therapy duration in atrial fibrillation patients after percutaneous coronary intervention depends on individual characteristics and bleeding risk. Antiplatelet therapy is crucial for post-coronary artery bypass graft and transcatheter aortic valve implantation; Aspirin (ASA) monotherapy is preferred. Antiplatelet therapy duration in peripheral artery disease depends on the scenario. Adding vorapaxar and cilostazol may benefit secondary prevention and claudication, respectively. Carotid artery disease patients with transient ischemic attack or stroke benefit from antiplatelet therapy and combining ASA and clopidogrel is more effective than ASA alone. The optimal duration of DAPT after carotid artery stenting is uncertain. Resistance to ASA and clopidogrel poses an incremental risk of deleterious cardiovascular events and stroke. The selection and duration of antiplatelet therapy in patients with cardiovascular disease requires careful consideration of both efficacy and safety outcomes. The use of combination therapies may provide added benefits but should be weighed against the risk of bleeding. Further research and clinical trials are needed to optimize antiplatelet treatment in different patient populations and clinical scenarios.
- Date of publication
- 2023
- Keyword
- DOI
- Identifier
- Resource type
- Article
- Rights statement
- In Copyright
- License
- Attribution 4.0 International
- Journal title
- Life
- Journal volume
- 13
- Journal issue
- 7
- Page start
- 1580
- Language
- English
- Version
- Publisher
- ISSN
- 2075-1729
- Publisher
- MDPI
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