Does one size really fit all? The case for personalized antiplatelet therapy in interventional cardiology.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Future cardiology Pub Date : 2024-01-01 Epub Date: 2024-08-02 DOI:10.1080/14796678.2024.2384217
Ahmed Elserwey, Richard J Jabbour, Nick Curzen
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Abstract

Cardiovascular disease is the leading cause of death worldwide. Dual antiplatelet therapy (DAPT), with aspirin plus a P2Y12 inhibitor, is currently recommended as a default for patients after acute coronary syndrome (ACS) and following percutaneous coronary intervention (PCI). However, controversies arise over the role of aspirin, the optimal duration of DAPT after drug-eluting stent (DES) implantation, the choice of P2Y12 inhibitor and the variability in individual responses to antiplatelet agents. Recent data indicate that monotherapy with a P2Y12 inhibitor may have adequate anti-ischemic effects with lower bleeding risk. Additionally, discrepancies in DAPT duration recommendations and the optimal P2Y12 inhibitor, provides more uncertainty. We ask the question "does one size really fits all?" or should a more personalized strategy should be implemented.

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"一刀切 "真的适合所有人吗?介入心脏病学中个性化抗血小板治疗的案例。
心血管疾病是导致全球死亡的主要原因。目前,急性冠状动脉综合征(ACS)后和经皮冠状动脉介入治疗(PCI)后的患者推荐使用阿司匹林加 P2Y12 抑制剂的双联抗血小板疗法(DAPT)。然而,阿司匹林的作用、药物洗脱支架(DES)植入后 DAPT 的最佳持续时间、P2Y12 抑制剂的选择以及个体对抗血小板药物反应的差异性等问题仍存在争议。最近的数据表明,P2Y12 抑制剂单药治疗可能具有充分的抗缺血作用,同时出血风险较低。此外,DAPT 持续时间建议与最佳 P2Y12 抑制剂之间的差异也增加了不确定性。我们不禁要问:"是'一刀切'真的适合所有人吗?
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来源期刊
Future cardiology
Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.80
自引率
5.90%
发文量
87
期刊介绍: Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.
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