Dual pathway inhibition in atherothrombosis prevention: yes, now we can!

Area of Science:

• Cardiology
• Vascular Medicine
• Pharmacology

Background:

• Atherothrombotic cardiovascular disease prevention and treatment remain significant clinical challenges.
• Current antithrombotic strategies include dual antiplatelet therapy (DAPT) and dual pathway inhibition (DPI).
• DPI combines an antiplatelet agent with a reduced-dose anticoagulant.

Purpose of the Study:

• To review current data on antithrombotic therapies for cardiocerebrovascular disease prevention.
• To guide the selection of appropriate antithrombotic strategies based on patient risk profiles.
• To emphasize personalized therapy for high-risk cardiovascular patients.

Main Methods:

• Analysis of randomized trials and observational registries spanning nearly thirty years.
• Comparison of DAPT and DPI efficacy in specific patient subgroups.
• Evaluation of treatment outcomes in patients with varying degrees of atherothrombotic involvement.

Main Results:

• DAPT demonstrates superiority over single antiplatelet therapy in high-risk patients post-coronary revascularization with drug-eluting stents (DES).
• DPI is superior to single antiplatelet therapy in patients with atherothrombosis across multiple vascular beds.
• Sufficient evidence exists to customize antithrombotic therapy for high-risk cardiovascular patients.

Conclusions:

• Personalized antithrombotic therapy is essential for optimizing outcomes in atherothrombosis.
• Selecting the right therapy (DAPT or DPI) for the right patient enhances efficacy and safety.
• Stakeholders must leverage current therapeutic opportunities for best patient care.