Potent P2Y₁₂ Inhibitor Monotherapy for Acute Coronary Syndrome

Dual antiplatelet therapy (DAPT), consisting of aspirin and a P2Y₁₂inhibitor, has been the principal antiplatelet therapy after drug-eluting stent (DES) implantation in patients with acute coronary syndrome (ACS) and chronic coronary disease. Particularly in patients with ACS, which presents a higher ischemic risk than chronic coronary artery disease, DAPT for up to 12 months is the recommended standard treatment. However, to decrease bleeding events related to the potency of P2Y₁₂inhibitors and a prolonged duration of DAPT, recent studies have suggested P2Y₁₂inhibitor monotherapy after short-term DAPT (1-3 months), which decreased the bleeding risk without an increased ischemic risk. In this article, we discuss the evidence related to the efficacy of a P2Y₁₂inhibitor as single-antiplatelet therapy after short-term DAPT compared with standard DAPT, with a focus on patients with ACS treated with DES.