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Thromb Haemost 2023; 123(02): 159-165
DOI: 10.1055/s-0042-1755330
Theme Issue Article

Platelet P2Y12 Inhibitor Monotherapy after Percutaneous Coronary Intervention: An Emerging Option for Antiplatelet Therapy De-escalation

Freek W. A. Verheugt 
1   Department of Cardiology, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
,
Kurt Huber
2   3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria
3   Medical Faculty, Sigmund Freud University, Vienna, Austria
,
Peter Clemmensen
4   Department of Cardiology, University Heart and Vascular Center Hamburg-Eppendorf, Hamburg, Germany
5   Department of Medicine, Nykøbing F Hospital, Nykøbing Falster, Denmark
,
Jean-Philippe Collet
6   Sorbonne Université, ACTION Group, INSERM UMRS 1166, HÔpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
,
Thomas Cuisset
7   Department of Cardiology, La Timone Hospital, Marseille, France
,
Felicita Andreotti
8   Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
› Author Affiliations Funding None.
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Abstract

Antiplatelet therapy is considered essential for secondary prevention of ischemic heart disease. After percutaneous coronary intervention (PCI), temporary dual antiplatelet therapy (DAPT), a combination consisting of aspirin and an oral P2Y12 receptor blocker, is recommended. In the long term, this strategy results in more bleeding than antiplatelet therapy with aspirin alone. Therefore, to reduce bleeding, an increasing trend has been to keep DAPT as short as clinically acceptable, after which aspirin monotherapy is continued. Another option to diminish bleeding is to discontinue aspirin at the moment of DAPT cessation after PCI, and to continue on P2Y12 blocker monotherapy. This survey reviews the evidence on P2Y12 blocker monotherapy. Some clinical guidance will be provided on when and in whom P2Y12 inhibitor monotherapy may be applied after DAPT cessation following PCI.

Keywords

aspirin - clopidogrel - ticagrelor - prasugrel - percutaneous coronary intervention


Publication History

Received: 15 March 2022

Accepted: 25 June 2022

Article published online:
30 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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