MedStar Authors catalog › Details for: Optimizing Monotherapy Selection, Aspirin Versus P2Y12 Inhibitors, Following Percutaneous Coronary Intervention. [Review]
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Optimizing Monotherapy Selection, Aspirin Versus P2Y12 Inhibitors, Following Percutaneous Coronary Intervention. [Review]

by Yerasi, Charan; Case, Brian C; Forrestal, Brian J; Torguson, Rebecca; Weintraub, William S; Garcia-Garcia, Hector M; Waksman, Ron.
Citation: American Journal of Cardiology. 2020 Aug 15.Journal: The American journal of cardiology.Published: ; 2020; FY2021ISSN: 0002-9149.Full author list: Yerasi C; Case BC; Forrestal BJ; Torguson R; Weintraub WS; Garcia-Garcia HM; Waksman R.UI/PMID: 32962804.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal Article | ReviewDigital Object Identifier: https://dx.doi.org/10.1016/j.amjcard.2020.07.061 (Click here) Abbreviated citation: Am J Cardiol. 2020 Aug 15.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Dual antiplatelet therapy (DAPT) reduces ischemic and thrombotic events after percutaneous coronary intervention (PCI). Initial reports of higher myocardial infarction and mortality rates prompted guideline committees to choose 12-month duration of DAPT after PCI. However, higher bleeding rates with DAPT remain a major concern. Since these guidelines were published, there have been improvements in stent design, deployment techniques, and antiplatelet therapies, which have reduced ischemic events. To address bleeding concerns, trials were performed to evaluate the effectiveness of short-duration DAPT. Two main strategies were employed: (1) aspirin monotherapy after a short-duration DAPT, and (2) P2Y12 inhibitor monotherapy after a short-duration DAPT. In this review, we outline all the major trials on short-duration DAPT that have examined the previously mentioned strategies and propose a new individualized treatment algorithm for which monotherapy to choose or remove after PCI. In conclusion, while removing the P2Y12 inhibitor after a short DAPT appears to be safe in the low-risk population, removing aspirin and continuing the P2Y12 inhibitor as monotherapy would be the preferred strategy in intermediate- to high-risk patients to mitigate the bleeding risk. Copyright (c) 2020 Elsevier Inc. All rights reserved.

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