J Cardiovasc Interv.  2024 Apr;3(2):62-71. 10.54912/jci.2024.0002.

Recent Evidence of Potent P2Y₁₂ Inhibitor Monotherapy After Short-term Dual Antiplatelet Therapy for Patients With Acute Coronary Syndrome

• Hong SJ

• KMID: 2560961
• DOI: http://doi.org/10.54912/jci.2024.0002

Abstract

For patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention, 12 months of dual antiplatelet therapy (DAPT) comprising aspirin and a P2Y₁₂ inhibitor is currently recommended as the standard treatment. However, several studies have suggested that the maintenance of DAPT for up to 12 months increases the risk of bleeding, which can be related to comorbidities and mortalities after bleeding events. Therefore, recent randomized clinical trials have indicated that short-term DAPT for 1 to 3 months followed by P2Y₁₂ inhibitor monotherapy is efficacious and safe compared to the 12-month maintenance of DAPT. P2Y₁₂ inhibitor monotherapy after short-term DAPT is associated with a lower incidence of major bleeding events without an increase in ischemic events, such as a composite of death, myocardial infarction, or stroke. This article discusses recent evidence of potent P2Y₁₂ inhibitor monotherapy after short-term DAPT, focusing on patients with ACS from randomized clinical trials and meta-analyses.

Keyword

Acute coronary syndrome; Percutaneous coronary intervention; Dual anti-platelet therapy