Journals / İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi / 2017 / Cilt: 24 - Sayı: 1

An update of dual antiplatelet therapy

Pages
105–116
Publication Date
2022-10-17
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Their benefits in terms of mortality and major cardiovascular events have been demonstrated, but some concerns remain regarding the possible increase in bleeding.The aim of this review was to summarize the current literature containing the potential solutions to problems related to indications and duration of dual antiplatelet therapy and its interaction with other medications.

📌 3 Key Takeaways

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Objective & Hypothesis:Since platelet activation and aggregation play a major role in thrombus formation in lumen of coronary arteries, they constitute a main target in treatment of stable ischemic heart disease and acute coronary syndromes.
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Key Findings & Data:Platelet functions can be inhibited by three classes of drugs having different mechanisms of action, namely acetylsalicylic acid, P2Y12 inhibitors, and glycoprotein IIb/IIIa antagonists.
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Conclusion & Impact:Their benefits in terms of mortality and major cardiovascular events have been demonstrated, but some concerns remain regarding the possible increase in bleeding.The aim of this review was to summarize the current literature containing the potential solutions to problems related to indications and duration of dual antiplatelet therapy and its interaction with other medications.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Since platelet activation and aggregation play a major role in thrombus formation in lumen of coronary arteries, they constitute a main target in treatment of stable ischemic heart disease and acute coronary syndromes. Antiplatelet therapy should be commenced as early as possible within the current indications in order to reduce the risk of both acute ischemic complications and recurrent atherothrombotic events. Platelet functions can be inhibited by three classes of drugs having different mechanisms of action, namely acetylsalicylic acid, P2Y12 inhibitors, and glycoprotein IIb/IIIa antagonists. Dual antiplatelet therapy (acetylsalicylic acid and P2Y12 inhibitors) have recently been a hot topic of research with the advent of stents in recent years. Multiple regimens of antiplatelet and anticoagulation therapy have been used in the past in patients undergoing percutaneous coronary intervention. The optimal duration of dual antiplatelet therapy after drug-eluting stent implantation is unclear. Many clinicians have pushed for prolonged dual antiplatelet therapy — beyond 12 months — on the assumption that extended therapy reduces recurrentcardiovascular events. Despite the established guidelines, there is not a clear consensus about how to manage antiplatelet therapy. New antiplatelet agents have been developed for patients at high risk of thrombosis. Their benefits in terms of mortality and major cardiovascular events have been demonstrated, but some concerns remain regarding the possible increase in bleeding.The aim of this review was to summarize the current literature containing the potential solutions to problems related to indications and duration of dual antiplatelet therapy and its interaction with other medications.

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Cite This Article

KELES, T., DURMAZ, T., AYHAN, H., KARADUMAN, B. D., BOZKURT, E. (2022). An update of dual antiplatelet therapy. İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi, Cilt: 24 - Sayı: 1, 105–116. https://ajindex.com/articles/549118

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References (8)

  1. Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007;357(20):2001–15.
  2. Dunn SP, Macaulay TE, Brennan DM, Campbell CL, Charnigo RJ, Smyth SS, et al. Baseline proton pump inhibitor use is associated with increased cardiovascular events with and without the use of clopidogrel in the CREDO Trial. Circulation. 2008;118 (1):815-6.
  3. Li XQ, Andersson TB, Ahlstrom M, Weidolf L. Comparison of inhibitory effects of the proton pumpinhibiting drugs omeprazole, esemeprazole, lansoprazole, pantoprazole and rabeprazole on human cytochrome P450 activities. Drug Metab Dispos 2004;32 (8):821-7.
  4. Bhatt DL, Scheiman J, Abraham NS, Antman EM, Chan FK, Furberg CD, et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointesti-nal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Consensus Documents. Circulation 2008;118 (3):1894-909.
  5. Dewilde WJ, Oirbans T, Verheugt FW, Kelder JC, De Smet BJ, Herrman JP, et al. WOEST study investigators. Use of clopidogrel with or without ASA in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;30;381 (9872):1107-15.
  6. Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010;31:2369-429.
  7. Hermosillo AJ, Spinler SA. Aspirin clopidogrel, and warfarin: is the combination appropriate and effective or inappropriate and too dangerous? Ann Pharmacother 2008;42 (6):790-805.
  8. Helft G, Le Feuvre C, Georges JL, Carrie D, Leclercq F, Eltchaninoff H, et al. Efficacy and safety of 12 versus 48 months of dual antiplatelet therapy after implantation of a drug-eluting stent: the OPTImal DUAL antiplatelet therapy (OPTIDUAL) trial: study protocol for a randomized controlled trial. Trials 2013;21;14:56. Byrne RA, Schulz S, Mehilli J, Iijima R, Massberg S, Neumann FJ, et al. Rationale and design of a randomized, double-blind, placebo-controlled trial of 6 versus 12 months clopidogrel therapy after implantation of a drug-eluting stent: The Intracoronary Stenting and Antithrombotic Regimen: Safety And EFficacy of 6 Months Dual Antiplatelet Therapy After Drug-Eluting Stenting (ISAR-SAF