Extended dual antiplatelet therapy after acute myocardial infarction. Current evidence and future perspectives

Area of Science:

• Cardiology
• Clinical Medicine
• Pharmacology

Background:

• Patients with acute myocardial infarction (AMI) have elevated risks of recurrent ischemic events post-discharge.
• Current guidelines recommend assessing residual ischemic risk to guide prolonged dual antiplatelet therapy (DAPT).
• Existing risk scores often lack applicability to AMI patients or are too complex for clinical practice.

Purpose of the Study:

• To review evidence on prolonged DAPT use in post-AMI patients.
• To focus on identifying high-risk individuals who may benefit from extended DAPT.
• To address the challenge of balancing clinical benefit against bleeding risk.

Main Methods:

• Review of current evidence on prolonged dual antiplatelet therapy after AMI.
• Analysis of recent advances in identifying high-risk patient populations.
• Consideration of net clinical benefit and bleeding risk.

Main Results:

• Optimal medical therapy alone may not suffice for all post-AMI patients.
• The identification of ideal candidates for prolonged DAPT remains challenging.
• Balancing ischemic risk reduction with bleeding risk is paramount.

Conclusions:

• Further research is needed to refine risk stratification for prolonged DAPT in AMI.
• Personalized therapeutic strategies are essential for managing post-AMI patients.
• Identifying patients with favorable net clinical benefit is key to optimizing DAPT duration.