P2Y(12) inhibitor monotherapy in patients undergoing percutaneous coronary intervention

Imagem de Miniatura
Arquivos
art_CAPODANNO_P2Y12_inhibitor_monotherapy_in_patients_undergoing_percutaneous_coronary_2022.PDF (2.33 MB)
Citações na Scopus
28
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
NATURE PORTFOLIO
Autores
CAPODANNO, Davide
BABER, Usman
BHATT, Deepak L.
COLLET, Jean-Philippe
DANGAS, George
FRANCHI, Francesco
GIBSON, C. Michael
GWON, Hyeon-Cheol
KASTRATI, Adnan
KIMURA, Takeshi
Citação
NATURE REVIEWS CARDIOLOGY, v.19, n.12, p.829-844, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
The evolution of stent design has reduced the incidence of stent thrombosis, meaning that the duration of dual antiplatelet therapy after percutaneous coronary intervention (PCI) might be shortened. In this Review, the authors describe the current evidence base and ongoing clinical trials into the use of P2Y(12) inhibitor monotherapy after PCI. For 20 years, dual antiplatelet therapy (DAPT), consisting of the combination of aspirin and a platelet P2Y(12) receptor inhibitor, has been the gold standard of antithrombotic pharmacology after percutaneous coronary intervention (PCI). In the past 5 years, several investigations have challenged this paradigm by testing the efficacy and safety of P2Y(12) inhibitor monotherapy (that is, without aspirin) following a short course of DAPT. Collectively, these studies suggested a reduction in the risk of major bleeding and no significant increase in thrombotic or ischaemic events compared with guideline-recommended DAPT. Current recommendations are evolving to inform clinical practice on the ideal candidates for P2Y(12) inhibitor monotherapy after PCI. Generalizing the results of studies of P2Y(12) inhibitor monotherapy requires a thorough understanding of their design, populations, interventions, comparators and results. In this Review, we provide an up-to-date overview on the use of P2Y(12) inhibitor monotherapy after PCI, including supporting pharmacodynamic and clinical evidence, practical recommendations and future directions.
Palavras-chave
URI
https://observatorio.fm.usp.br/handle/OPI/51789
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Coleções
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - ODS/03