Kevin R Bainey, Guillaume Marquis-Gravel, Emilie Belley-Côté, Ricky D Turgeon, Margaret L Ackman, Hazal E Babadagli, David Bewick, Laurie-Anne Boivin-Proulx, Warren J Cantor, Stephen E Fremes, Michelle M Graham, Marie Lordkipanidzé, Mina Madan, Samer Mansour, Shamir R Mehta, Brian J Potter, Jay Shavadia, Derek F So, Jean-François Tanguay, Robert C Welsh, Andrew T Yan, Akshay Bagai, Rodrigo Bagur, Claudia Bucci, Basem Elbarouni, Carol Geller, Andrea Lavoie, Patrick Lawler, Shuangbo Liu, John Mancini, Graham C Wong
Antiplatelet therapy (APT) is the foundation of treatment and prevention of atherothrombotic events in patients with atherosclerotic cardiovascular disease. Selecting the optimal APT strategies to reduce major adverse cardiovascular events, while balancing bleeding risk, requires ongoing review of clinical trials. Appended, the focused update of the Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology guidelines for the use of APT provides recommendations on the following topics: (1) use of acetylsalicylic acid in primary prevention of atherosclerotic cardiovascular disease; (2) dual APT (DAPT) duration after percutaneous coronary intervention (PCI) in patients at high bleeding risk; (3) potent DAPT (P2Y12 inhibitor) choice in patients who present with an acute coronary syndrome (ACS) and possible DAPT de-escalation strategies after PCI; (4) choice and duration of DAPT in ACS patients who are medically treated without revascularization; (5) pretreatment with DAPT (P2Y12 inhibitor) before elective or nonelective coronary angiography; (6) perioperative and longer-term APT management in patients who require coronary artery bypass grafting surgery; and (7) use of APT in patients with atrial fibrillation who require oral anticoagulation after PCI or medically managed ACS...
October 29, 2023: Canadian Journal of Cardiology