Dual Antiplatelet Therapy in Patients with Stable Ischemic Heart Disease

Dual antiplatelet therapy (DAPT) is the use of a P2Y12 receptor antagonist (clopidogrel, prasugrel, or ticagrelor) in combination with aspirin. Recommendations for its use are primarily in patients who have experienced acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) in the preceding 12 months. There is a growing body of evidence, however, investigating the use of long-duration DAPT in patients with stable ischemic heart disease (SIHD). SIHD is defined as clinical evidence of ischemic heart disease, without an ACS event in the preceding 12 months, and includes patients with stable angina, elective PCI, and remote history of ACS. The use of DAPT in the SIHD population and the recent advancements in our understanding of its use are the focus of this review.