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Duration of Dual Antiplatelet Therapy in Coronary Artery Disease: a Review Article

  • Cardiovascular Disease and Stroke (S. Prabhakaran, Section Editor)
  • Published:
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Abstract

Dual antiplatelet therapy (DAPT) following an acute coronary syndrome or after placement of a coronary artery stent is superior to aspirin alone for prevention of atherothrombotic events but carries an increased bleeding risk. DAPT should be continued for at least 12 months based on current guidelines. Recent randomized trials demonstrate reduced ischemic events including myocardial infarction (MI), stroke, and death with continued DAPT for up to 30 months or longer, particularly in the post-MI population. However, this clinical benefit is accompanied by an increased risk of bleeding. Additional trials show mixed safety and efficacy with duration of DAPT of less than 12 months. The current data emphasizes the need to individualize DAPT duration at the patient level to balance the clinical benefits of a reduced risk of cardiovascular ischemic events with the greater risk of clinically significant bleeding. Patients at an increased risk of ischemic events and a lower risk of bleeding should be strongly considered for prolonged DAPT beyond the 1 year currently recommended in the practice guidelines.

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Authors and Affiliations

  1. Rush University Medical Center, 1653 W Congress Parkway, Chicago, IL, 60612, USA

    Alex D. Moseley, Fareed M. Collado, Annabelle Santos Volgman, Gary L. Schaer & R. Jeffrey Snell

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  1. Alex D. Moseley
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  2. Fareed M. Collado
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  3. Annabelle Santos Volgman
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  4. Gary L. Schaer
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Correspondence to R. Jeffrey Snell.

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Alex D. Moseley, Fareed M. Collado, Annabelle Santos Volgman, and R. Jeffrey Snell declare that they have no conflict of interest.

Gary L. Schaer declares personal fees from AstraZeneca and The Medicines Company for advisory board and consultancy work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Cardiovascular Disease and Stroke

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Moseley, A.D., Collado, F.M., Volgman, A.S. et al. Duration of Dual Antiplatelet Therapy in Coronary Artery Disease: a Review Article. Curr Atheroscler Rep 18, 45 (2016). https://doi.org/10.1007/s11883-016-0595-0

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