
Long-term dual antiplatelet therapy: pharmacological and clinical implications
Author(s) -
Carlo Di Mario,
Alessandro Mugelli,
Pasquale Perrone Filardi,
Giuseppe Rosano,
Francesco Rossi
Publication year - 2018
Publication title -
journal of cardiovascular medicine
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.458
H-Index - 47
eISSN - 1558-2035
pISSN - 1558-2027
DOI - 10.2459/jcm.0000000000000677
Subject(s) - medicine , acute coronary syndrome , myocardial infarction , residual risk , intensive care medicine , platelet aggregation inhibitor , medical prescription , cardiology , major bleeding , aspirin , pharmacology
: Patients experiencing an acute coronary syndrome are exposed to an increased residual risk of recurrent coronary events. Dual antiplatelet therapy (DAPT) is highly effective in preventing atherothrombotic complications in patients with previous myocardial infarction and current guidelines recommend the prescription of DAPT for at least 12 months in all patients experiencing an acute event. However, recent findings demonstrated that long-term DAPT (over 12 months) is related to a better outcome in patients at high risk, suggesting the use of a long-term DAPT to achieve a better clinical outcome. The choice of DAPT duration is still a difficult issue and a personalized approach to the patients is mandatory to manage both the residual ischemic risk and the risk of bleeding events.The aim of this review is to analyze the pharmacological characteristics of available antiplatelet agents and to revise the use of DAPT in clinical practice, focusing on the benefits of a long-term approach.