4.4 Review

Summary of the European Society of Cardiology guidelines on dual antiplatelet therapy in patients after percutaneous coronary interventions

Journal

KARDIOLOGIA POLSKA
Volume 80, Issue 10, Pages 974-989

Publisher

POLISH CARDIAC SOC-POLSKIE TOWARZYSTWO KARDIOLOGICZNE
DOI: 10.33963/KP.a2022.0198

Keywords

clopidogrel; dual antiplatelet therapy; percutaneous coronary intervention; prasugrel; ticagrelor

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This review summarizes ESC guidelines on dual antiplatelet therapy post-PCI, compiling recommendations into one document and creating an algorithm for quick navigation on DAPT selection based on ischemic and bleeding risks. The review also includes important studies, meta-analyses, and practical pointers for managing bleeding complications and urgent surgery in DAPT patients.
This review is a summary of the European Society of Cardiology (ESC) guidelines focused on dual antiplatelet therapy in patients after percutaneous coronary interventions (PCI). Given a large num-ber of recommendations concerning antiplatelet therapy published in various ESC guidelines, the main goal of this paper was to compile these separate recommendations into one document. In addition, we set out to present the current state of knowledge and create an algorithm that would be based on all of these guidelines in hope that it would allow quick navigation when selecting the type and duration of dual antiplatelet therapy (DAPT) depending on the clinical scenario with a special emphasis on evaluating both ischemic and bleeding risks. The review is based on the ESC guidelines on the diagnosis and management of chronic coronary syndromes (2019), revascularization (2018), acute myocardial infarction in patients presenting with ST-segment elevation myocardial infarction (STEMI) (2017), DAPT (2017), and acute coronary syndromes in patients presenting without persistent ST-segment elevation (NSTE-ACS) (2020).The review also provides brief information on the most important studies and meta-analyses in this area, as well as practical pointers for management in the case of bleeding complications and before urgent surgery in patients on DAPT.

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