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Antiplatelet therapy regimen and duration after percutaneous coronary intervention: Combining prediction scores with clinical judgment
Author(s) -
Ashley Kellan E.,
Hillegass William B.
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29573
Subject(s) - medicine , ticagrelor , percutaneous coronary intervention , regimen , conventional pci , aspirin , duration (music) , clopidogrel , cardiology , myocardial infarction , art , literature
Key Points The dual antiplatelet therapy (DAPT) score “decouples” overlapping risk factors for ischemic and bleeding events informing clinical decisions on the optimal duration of antiplatelet therapy after percutaneous coronary intervention (PCI). In patients with DAPT Scores <2 which generally favors short duration therapy, the current meta‐analysis suggests the GLOBAL LEADERS trial regimen of 1 month of aspirin plus ticagrelor followed by 23 months of ticagrelor monotherapy appears uniquely promising when prolonged P2Y 12 therapy may be otherwise desirable in these patients. Risk scores should be developed informing BOTH optimal antiplatelet regimen (such as P2Y 12 monotherapy) and treatment duration after PCI. Individual patient treatment decisions should incorporate these scores and clinical meta‐judgment on relevant additional extenuating factors including candidate factors statistically rejected during derivation of these scores.