SYNOPSIS: The authors of a single-center study randomized post-acute coronary syndrome patients either to remain on higherpotency antiplatelet agents or to change to clopidogrel after one month. The results showed a benefit to de-escalation in terms of both bleeding and ischemic events, regardless of initial platelet reactivity.
SOURCE: Deharo P, Quilici J, Camoin-Jau L, et al. Benefit of switching dual antiplatelet therapy after acute coronary syndrome according to on-treatment platelet reactivity: The TOPIC-VASP pre-specified analysis of the TOPIC randomized study. JACC Cardiovasc Interv 2017;10:2560-2570.