EuroPCR25th annual meeting of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Paris20-23 May 2014

EuroPCR 2014Paris

20-23 May 2014

Optimal duration of dual antiplatelet therapy

Commentary:

Dr Greg StarmerCairns Hospital

Date of preparation May 2014 │BRI001132

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EuroPCR 2014Paris

20-23 May 2014

EuroPCR 2014Paris

20-23 May 2014

EuroPCR 2014Paris

20-23 May 2014

EuroPCR 2014Paris

20-23 May 2014

EuroPCR 2014Paris

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EuroPCR 2014Paris

20-23 May 2014

EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

20-23 May 2014

EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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• Recommended durations of dual antiplatelet therapy, whether with clopidogrel, prasugrel or ticagrelor in addition to aspirin, are largely arbitrary. The optimal duration remains unknown.

• Current clinical trials, including the DAPT and ISAR-SAFE, will help to define the optimal duration of dual antiplatelet therapy.

• There is increased support for tailoring therapy to individual patients, for example 3-6 months for uncomplicated cases but >12 months in more complex cases (eg bifurcation stents, unprotected left main disease or long stents).

• With tailored therapy, it may be reasonable to briefly interrupt DAPT in ACS patients needing elective but semi-urgent surgery.

Commentary: Dr Greg Starmer

EuroPCR 2014Paris

20-23 May 2014

• More evidence is needed to guide the choice of antiplatelet therapy in patients also requiring anticoagulation, as triple therapy (DAPT + warfarin) carries a high bleeding risk and should generally be minimised.

• For the time being, novel oral anticoagulants are being regarded as equivalent to warfarin in this context, but more data are needed.

Commentary: Dr Greg Starmer