Antiplatelet Therapy in Heart Disease

Area of Science:

• Cardiology
• Pharmacology
• Thrombosis

Background:

• Antiplatelet therapy is vital for managing atherosclerotic cardiovascular diseases and preventing thrombotic events.
• Its role in primary prevention is limited due to bleeding risks, while secondary prevention benefits stable patients.
• Dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitors improves outcomes in acute coronary syndromes.

Purpose of the Study:

• To review the evolution of antiplatelet treatment strategies in heart diseases.
• To highlight current practices, special population considerations, and post-structural cardiac intervention regimens.
• To discuss advancements in tailoring antiplatelet therapy for improved efficacy and safety.

Main Methods:

• Review of pivotal studies and current guidelines on antiplatelet therapy.
• Analysis of evidence regarding dual vs. monotherapy and different P2Y12 inhibitors.
• Integration of data on stent technology and patient-specific risk profiles.

Main Results:

• Long-term monotherapy benefits stable secondary prevention patients.
• DAPT (aspirin + P2Y12 inhibitor) is superior to aspirin alone in acute coronary syndromes, with prasugrel and ticagrelor offering potent effects.
• Individualized risk assessment is crucial due to increased bleeding risks with intensive regimens.

Conclusions:

• Current guidelines emphasize individualized antiplatelet therapy duration and intensity.
• Advancements in stent technology and risk profiling enable tailored strategies.
• Novel agents and personalized approaches are shaping a patient-centered future for antiplatelet therapy in cardiovascular disease.