Duration of Dual Antiplatelet Therapy After Coronary Stenting A Review of the Evidence

被引:90
|
作者
Montalescot, Gilles [1 ]
Brieger, David [2 ]
Dalby, Anthony J. [3 ]
Park, Seung-Jung [4 ]
Mehran, Roxana [5 ]
机构
[1] Ctr Hosp Univ Pitie Salpetriere, AP HP, ACT Study Grp, Inst Cardiol, F-75013 Paris, France
[2] Univ Sydney, Dept Cardiol, Concord Hosp, Sydney, NSW 2006, Australia
[3] Milpk Hosp, Johannesburg, South Africa
[4] Univ Ulsan Coll Med, Asan Med Ctr, Div Cardiol, Seoul, South Korea
[5] Icahn Sch Med Mt Sinai, Cardiovasc Res Fdn, New York, NY 10029 USA
关键词
antiplatelet therapy; aspirin; coronary stent; drug-eluting stent; P2Y(12) inhibitors; DRUG-ELUTING STENTS; ACUTE MYOCARDIAL-INFARCTION; SECONDARY PREVENTION; CLINICAL-OUTCOMES; HEART-ASSOCIATION; POOLED ANALYSIS; PLUS ASPIRIN; BARE-METAL; THROMBOSIS; INTERVENTION;
D O I
10.1016/j.jacc.2015.05.053
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The duration of dual antiplatelet therapy (DAPT) after coronary stenting has been evaluated in randomized studies with apparently conflicting results. Although longer exposure associates with more bleeding complications, late stent thrombosis (ST) and myocardial infarction are reduced. In addition, as new drug-eluting stents carry a lower risk of ST compared with the first-generation drug-eluting stents and possibly even bare-metal stents, a shift toward better protection from ST may have an effect on the duration and intensity of DAPT. Whether the duration of DAPT should be shorter or longer than the currently recommended 6 to 12 months is analyzed in this review, drawing on lessons from the most recent studies. (J Am Coll Cardiol 2015; 66: 832-47) (C) 2015 by the American College of Cardiology Foundation.
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页码:832 / 847
页数:16
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