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[Adherence to antiplatelet therapy in patients with coronary artery disease]

D Legrand1, V Legrand

  • 1Service de cardiologie, CHU de Liège, Belgique.

Revue Medicale De Liege
|August 6, 2010
PubMed

Insights

Dual antiplatelet therapy is crucial for cardiovascular disease and PCI, but resistance and poor compliance lead to recurrent events. This review covers the latest data on compliance, resistance, and recommendations for antiplatelet therapy.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Antiplatelet therapy, including dual antiplatelet therapy (DAPT), is a cornerstone in managing cardiovascular disease and after percutaneous coronary intervention (PCI).
  • Despite established benefits, recurrent cardiovascular events remain a significant clinical challenge.

Purpose of the Study:

  • To review current data on patient compliance and antiplatelet resistance.
  • To discuss the impact of non-compliance and resistance on cardiovascular outcomes and stent thrombosis.
  • To outline updated recommendations for antiplatelet therapy.

Main Methods:

  • Literature review of recent studies on antiplatelet therapy, compliance, and resistance.
  • Analysis of data linking compliance and resistance to clinical events.
  • Synthesis of current guidelines and expert opinions.

Main Results:

  • Poor compliance and aspirin/clopidogrel resistance are identified as primary contributors to recurrent cardiovascular events.
  • Non-compliance is particularly critical in the first six months post-acute coronary syndromes and PCI.
  • Interruption of antiplatelet treatment is strongly associated with late and very late stent thrombosis.

Conclusions:

  • Optimizing compliance and addressing antiplatelet resistance are essential for improving outcomes in patients treated with DAPT.
  • Adherence to antiplatelet therapy is critical for preventing stent thrombosis, especially in the early and late periods after PCI.
  • Current recommendations emphasize monitoring and strategies to enhance patient adherence and overcome resistance.

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