Coronary disease & ACSGuideline or statement
Antithrombotic therapy for secondary prevention in patients with acute coronary syndromes treated with percutaneous coronary intervention: options for personalization to reduce bleeding or ischaemic risks. A Clinical Consensus Statement of the ESC Working Group on Thrombosis, the Association for Acute CardioVascular Care of the ESC, the European Association of Percutaneous Cardiovascular Interventions of the ESC, and the ESC Working Group on Cardiovascular Pharmacology A Clinical Consensus Statement of the ESC Working Group on Thrombosis, the Association for Acute CardioVascular Care of the ESC, the European Association of Percutaneous Cardiovascular Interventions of the ESC, and the ESC Working Group on Cardiovascular Pharmacology
- Clinical Consensus Statement
Recommendations
As issued by the authors
Amongst patients at high bleeding risk (HBR), standard dual antiplatelet therapy (DAPT), in comparison to abbreviated or de-escalated DAPT, increases the net risk of major adverse events, even in the presence of high ischaemic risk.
Conversely, amongst patients at high ischaemic risk, without HBR, prolonged dual antithrombotic therapy reduces longer-term thrombotic risk.
Recognizing risk factors and assessing the magnitude of bleeding and ischaemic risks are essential.
Since there are no ideal scoring systems to balance ischaemic and bleeding risks, and many overlap, focus should be on managing the risk most amenable to modification, namely bleeding, which should dominate the decision-making over ischaemic risk when choosing a DAPT regimen.
Original publication
Summarised from the published abstract; every number is checked against it