Oral antiplatelet therapy and percutaneous coronary intervention

Area of Science:

• Cardiology
• Pharmacology
• Interventional Cardiology

Background:

• Oral antiplatelet therapy is standard after percutaneous coronary intervention (PCI) with stenting.
• Dual antiplatelet therapy (DAPT) combining aspirin with clopidogrel or ticlopidine is more effective than aspirin alone for preventing thrombotic events.
• Clopidogrel is preferred over ticlopidine due to similar efficacy and a better safety profile.

Purpose of the Study:

• To review the established benefits and ongoing controversies in antiplatelet therapy post-PCI.
• To highlight recent evidence regarding optimizing DAPT in high-risk patient populations.

Main Methods:

• Review of existing literature and clinical evidence on antiplatelet therapy following PCI.
• Analysis of comparative studies on different antiplatelet agents and regimens.

Main Results:

• DAPT significantly reduces thrombotic events compared to aspirin monotherapy after PCI.
• Clopidogrel demonstrates comparable efficacy to ticlopidine with improved safety.
• Despite DAPT, residual risk of vascular events persists, indicating a need for optimized strategies.

Conclusions:

• Clopidogrel-based DAPT is a cornerstone of post-PCI care.
• Optimal timing, duration, and dosage of DAPT require further investigation, particularly for high-risk patients.
• Emerging evidence supports pretreatment, high loading doses, and long-term DAPT in select high-risk individuals to improve outcomes.