Personalized Dual Antiplatelet Therapy in Acute Coronary Syndromes: Striking a Balance Between Bleeding and Thrombosis.

ABSTRACT:

Purpose of review

Dual antiplatelet therapy (DAPT)-aspirin in conjunction with a P2Y₁₂ inhibitor-is the cornerstone of managing patients with acute coronary syndromes post-revascularization, but the clinical response is highly variable, with potentially devastating consequences. Herein, we review the mechanisms underpinning said variability and explore emerging approaches to normalizing therapeutic benefit.

Recent findings

The potent P2Y₁₂ inhibitors, prasugrel and ticagrelor, exhibit minimal inter-individual variability, replacing clopidogrel in DAPT and achieving greater rates of therapeutic response. However, these benefits decline in later phases when bleeding risk begins to supersede that of ischemia. Guided de-escalation of P2Y₁₂ inhibi

SUBMITTER: Shpigelman J 

PROVIDER: S-EPMC10307718 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature