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Role of Monotherapy with a P2Y12 Inhibitor for Secondary Prevention in Patients with Established Atherosclerosis

Juan J Rodriguez1,2, Luis E Baron1,3, Oscar C Munoz4

  • 1Texas Tech University Health Sciences Center, El paso, TX, USA.

Current Cardiology Reports
|January 14, 2022
PubMed
Abstract

Insights

P2Y12 inhibitor monotherapy is as effective as dual antiplatelet therapy for preventing cardiovascular events. Individual patient factors and bleeding risk should guide the choice of antiplatelet regimen for secondary prevention.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Secondary prevention of cardiovascular diseases (CVD) is crucial.
  • Dual antiplatelet therapy (DAPT) is a common strategy.
  • P2Y12 inhibitors are key antiplatelet agents.

Purpose of the Study:

  • To review evidence on P2Y12 inhibitor monotherapy for secondary CVD prevention.
  • To assess efficacy across major vascular territories.

Main Methods:

  • Systematic review of randomized controlled trials.
  • Inclusion of a recent large meta-analysis.

Main Results:

  • P2Y12 monotherapy shows no significant difference in all-cause death, vascular death, or stroke compared to DAPT.
  • A minor difference in myocardial infarction risk was observed.
  • P2Y12 inhibitor monotherapy appears comparable to aspirin monotherapy in efficacy.

Conclusions:

  • P2Y12 inhibitor monotherapy is a viable option for secondary CVD prevention.
  • Clinical context and bleeding risk are critical for selecting optimal antiplatelet therapy.
Keywords:
Antiplatelet therapyAtherosclerosic diseaseMonotherapyMyocardial infarctionPeripheral arterial diseaseSecondary preventionStroke

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