Individualization of Duration of Dual Antiplatelet Therapy after Coronary Stenting: A Comprehensive, Evidence-Based, Review

Gabriele Carciotto; Francesco Costa; Victoria Garcia-Ruiz; Mattia Galli; Emmanuele Soraci; Alberto Magliarditi; Lucio Teresi; Enrica Nasso; Scipione Carerj; Gianluca Di Bella; Antonio Micari; Giuseppe De Luca

doi:10.20944/preprints202310.1026.v1

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preprints.org > medicine and pharmacology > cardiac and cardiovascular systems > doi: 10.20944/preprints202310.1026.v1

Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Individualization of Duration of Dual Antiplatelet Therapy after Coronary Stenting: A Comprehensive, Evidence-Based, Review

Version 1 : Received: 14 October 2023 / Approved: 16 October 2023 / Online: 17 October 2023 (08:13:01 CEST)

A peer-reviewed article of this Preprint also exists.

Carciotto, G.; Costa, F.; Garcia-Ruiz, V.; Galli, M.; Soraci, E.; Magliarditi, A.; Teresi, L.; Nasso, E.; Carerj, S.; Di Bella, G.; Micari, A.; De Luca, G. Individualization of Duration of Dual Antiplatelet Therapy after Coronary Stenting: A Comprehensive, Evidence-Based Review. J. Clin. Med. 2023, 12, 7144. Carciotto, G.; Costa, F.; Garcia-Ruiz, V.; Galli, M.; Soraci, E.; Magliarditi, A.; Teresi, L.; Nasso, E.; Carerj, S.; Di Bella, G.; Micari, A.; De Luca, G. Individualization of Duration of Dual Antiplatelet Therapy after Coronary Stenting: A Comprehensive, Evidence-Based Review. J. Clin. Med. 2023, 12, 7144.

Abstract

Dual antiplatelet therapy (DAPT), comprising aspirin and a P2Y12 receptor inhibitor, is the cornerstone of post-percutaneous coronary intervention treatment to prevent stent thrombosis and reduce the risk of adverse cardiovascular events. The selection of an optimal DAPT regimen, considering the interplay of various antiplatelet agents, patient profiles, and procedural characteristics, remains an evolving challenge. Traditionally, a standard duration of 12 months has been recommended for DAPT in most patients. While contemporary guidelines provide general frameworks, DAPT modulation with longer or shorter treatment courses followed by aspirin or P2Y12 inhibitor monotherapy are evolving towards an individualized strategy to optimize the balance between efficacy and safety. This review comprehensively examines the current landscape of DAPT strategies after coronary stenting, with a focus on emerging evidence for treatment individualization.

Keywords

dual antiplatelet therapy; Percutaneous coronary intervention; acute coronary syndrome; bleeding risk; tailored therapy

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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