Duration of Dual Antiplatelet Therapy in the Post–Acute Coronary Syndrome Patient

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Abstract

Background:

After acute coronary syndrome, guidelines recommend dual antiplatelet therapy with aspirin and a P2Y12 inhibitor for a period of 12 months for the prevention of secondary cardiovascular events. However, the risk of recurrent ischemic events can persist beyond 12 months, and there has been much debate regarding the benefits of prolonging dual antiplatelet therapy in certain patient populations.

Purpose:

The purpose of this review was to investigate the optimal duration of dual antiplatelet therapy in the post–acute coronary syndrome patient.

Conclusion:

Extended dual antiplatelet therapy has been associated with an increased risk of bleeding, which must be considered along with the anti-ischemic benefits of dual antiplatelet therapy when deciding on the optimal treatment duration for individual patients.

Clinical Implications:

Treatment duration must be tailored to the patient after a thorough evaluation of individual ischemic and bleeding risk factors.

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