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Dual anti-platelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is the current gold standard for the treatment of acute coronary syndrome (ACS). Clopidogrel or ticagrelor are the preferred P2Y12 inhibitor options for initial therapy. Ticagrelor has been demonstrated to have improved efficacy, and is preferred over clopidogrel in the absence of contraindications or the need for oral anticoagulation.

The main risk associated with all antiplatelet therapies is bleeding, and physicians need to carefully weigh the possible adverse effects against the benefits of prescribing these drugs to patients with ACS. Aspirin continues to be prescribed almost ubiquitously for patients with ACS, and P2Y12 antagonists are now often added in; such dual antiplatelet therapy confers greater antithrombotic efficacy but at the risk of increased bleeding. Over recent years, it has become apparent that these drugs may also exert powerful anti-inflammatory effects that provide additional benefit in the management of ACS.

Articles

APSC Consensus Recommendations on High-risk Chronic Coronary Syndrome

Published:

18 June 2021

Citation:

European Cardiology Review 2021;16:e26.

Pharmacotherapy in Stable CAD: The ISCHEMIA Trial

Published:

03 March 2021

Citation:

European Cardiology Review 2021;16:e04.

2020 APSC Consensus Recommendations on P2Y12 Inhibitor Use

Published:

02 March 2021

Citation:

European Cardiology Review 2021;16:e02.

Antithrombotic Therapy After TAVI

Published:

26 February 2020

Citation:

European Cardiology Review 2020;15:e09.