Antithrombotic Therapy in Patients with Chronic Coronary Syndromes

Area of Science:

• Cardiology
• Pharmacology
• Interventional Cardiology

Background:

• Current antithrombotic management for chronic coronary syndrome (CCS) involves dual antiplatelet therapy (DAPT) and anticoagulation, with specific protocols post-percutaneous coronary intervention (PCI).
• Advancements in stent technology have reduced stent thrombosis risk, shifting focus towards minimizing bleeding complications.
• The impact of bleeding on patient prognosis is increasingly recognized, necessitating revised therapeutic approaches.

Purpose of the Study:

• To review current European and American guidelines for antithrombotic therapy in CCS.
• To explore novel therapeutic strategies for CCS management, particularly after PCI.
• To balance the need for ischemic event protection with the reduction of long-term bleeding risk.

Main Methods:

• Review of existing European and American guidelines for CCS management.
• Analysis of current antithrombotic strategies, including dual antiplatelet therapy (DAPT) and anticoagulation protocols.
• Examination of investigational therapeutic strategies and their potential impact on ischemic and bleeding events.

Main Results:

• Established guidelines recommend specific DAPT durations and anticoagulation regimens for CCS patients.
• Newer strategies aim to optimize initial post-PCI treatment for ischemia prevention.
• Long-term management focuses on transitioning to safer antithrombotic regimens to reduce bleeding risk.

Conclusions:

• Therapeutic strategies for CCS are evolving due to improved stent technology and a focus on bleeding risk.
• Balancing antithrombotic efficacy and safety is crucial for long-term patient outcomes.
• Investigational approaches hold promise for refining CCS management in the future.