TY - JOUR
T1 - P2Y12 inhibitor monotherapy in patients undergoing percutaneous coronary intervention
AU - Capodanno, Davide
AU - Baber, Usman
AU - Bhatt, Deepak L.
AU - Collet, Jean Philippe
AU - Dangas, George
AU - Franchi, Francesco
AU - Gibson, C. Michael
AU - Gwon, Hyeon Cheol
AU - Kastrati, Adnan
AU - Kimura, Takeshi
AU - Lemos, Pedro A.
AU - Lopes, Renato D.
AU - Mehran, Roxana
AU - O’Donoghue, Michelle L.
AU - Rao, Sunil V.
AU - Rollini, Fabiana
AU - Serruys, Patrick W.
AU - Steg, Philippe G.
AU - Storey, Robert F.
AU - Valgimigli, Marco
AU - Vranckx, Pascal
AU - Watanabe, Hirotoshi
AU - Windecker, Stephan
AU - Angiolillo, Dominick J.
N1 - Publisher Copyright:
© 2022, Springer Nature Limited.
PY - 2022/12
Y1 - 2022/12
N2 - For 20 years, dual antiplatelet therapy (DAPT), consisting of the combination of aspirin and a platelet P2Y12 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 P2Y12 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 P2Y12 inhibitor monotherapy after PCI. Generalizing the results of studies of P2Y12 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 P2Y12 inhibitor monotherapy after PCI, including supporting pharmacodynamic and clinical evidence, practical recommendations and future directions.
AB - For 20 years, dual antiplatelet therapy (DAPT), consisting of the combination of aspirin and a platelet P2Y12 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 P2Y12 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 P2Y12 inhibitor monotherapy after PCI. Generalizing the results of studies of P2Y12 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 P2Y12 inhibitor monotherapy after PCI, including supporting pharmacodynamic and clinical evidence, practical recommendations and future directions.
UR - http://www.scopus.com/inward/record.url?scp=85131864232&partnerID=8YFLogxK
U2 - 10.1038/s41569-022-00725-6
DO - 10.1038/s41569-022-00725-6
M3 - Review article
C2 - 35697777
AN - SCOPUS:85131864232
SN - 1759-5002
VL - 19
SP - 829
EP - 844
JO - Nature Reviews Cardiology
JF - Nature Reviews Cardiology
IS - 12
ER -