Long-term residual cardiovascular risk after acute coronary syndrome: antithrombotic treatment options

Area of Science:

• Cardiology
• Thrombosis Research
• Clinical Medicine

Background:

• Residual thrombotic risk persists one year after acute coronary syndromes (ACS) despite secondary prevention.
• Dual antiplatelet therapy (DAPT) is standard for 12 months but carries bleeding risks.
• Prolonging DAPT beyond 12 months increases bleeding complications.

Purpose of the Study:

• To review residual thrombotic risk at one year post-ACS.
• To evaluate evidence for antithrombotic therapies beyond one year.
• To provide guidance on selecting patients for extended antithrombotic treatment.

Main Methods:

• Literature review of studies on antithrombotic therapies post-ACS.
• Analysis of clinical trial data regarding ischemic and bleeding events.
• Synthesis of evidence to create a practical patient selection guide.

Main Results:

• Assessing both ischemic and bleeding risks is critical for patients at one year post-ACS.
• Low-dose rivaroxaban plus aspirin demonstrates efficacy in reducing ischemic events.
• Risk stratification is essential for optimizing antithrombotic strategies.

Conclusions:

• Individualized risk assessment is key for managing patients post-ACS.
• Extended antithrombotic therapy options exist beyond standard DAPT.
• Careful patient selection can mitigate residual thrombotic risk while minimizing bleeding complications.