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Lights and shadows of long-term dual antiplatelet therapy in 'real life' clinical scenarios
- Publication Year :
- 2018
-
Abstract
- Dual antiplatelet therapy (DAPT) is a cornerstone of treatment for patients with acute coronary syndromes (ACS). Mounting evidences have opened the debate about the optimal DAPT duration. Considering the ACS-pathophysiology, the most recent guidelines recommend DAPT in all ACS patients for at least 12 months unless there are contraindications such as excessive risk of bleeding. Thus, it can be considered acceptable earlier discontinuation if the risk of morbidity from bleeding outweighs the anticipated benefit. On the other hand, several studies have clearly indicated that a significant burden of platelet related-events, such as stroke and new ACS might occur after this period, suggesting that potential benefits might derive by prolonging DAPT beyond 12 months (Long DAPT). Indeed, although current guidelines give some indications about patients eligible for Long DAPT, they do not embrace several real-life clinical scenarios. Thus, in such scenarios, how to decide whether a patient is eligible for Long DAPT or not might be still challenging for clinicians. This position paper presents and discusses various “real-life” clinical scenarios in ACS patients, in order to propose several possible recommendations to overcome guidelines potential limitations.
- Subjects :
- medicine.medical_specialty
Acute coronary syndrome
animal structures
MEDLINE
Hemorrhage
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Recurrence
medicine
Secondary Prevention
In real life
Humans
Antiplatelet
030212 general & internal medicine
Intensive care medicine
Patient management
Stroke
business.industry
Hematology
medicine.disease
Long-Term Care
Discontinuation
Term (time)
Long-term care
Treatment Outcome
Long-term DAPT
Practice Guidelines as Topic
Position paper
DAPT
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....ed880cc1ef201b9a09d31b3b969fed4a