Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with chronic coronary artery disease (CAD) - current state of knowledge and perspective for further research
Introduction and purpose: aa Chronic coronary artery disease (CAD) is a prevalent condition affecting millions of people worldwide, significantly reducing quality of life and increasing the risk of myocardial infarction (MI). Percutaneous coronary intervention (PCI), often combined with stent impla...
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Kazimierz Wielki University
2025-02-01
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| Series: | Journal of Education, Health and Sport |
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| Online Access: | https://apcz.umk.pl/JEHS/article/view/57718 |
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| author | Hubert Bochenek Anna Bielicka Michał Bzoma Julia Gugulska Irmina Czerepak Marcin Kapij Karolina Niewczas Adrianna Brzozowska |
| author_facet | Hubert Bochenek Anna Bielicka Michał Bzoma Julia Gugulska Irmina Czerepak Marcin Kapij Karolina Niewczas Adrianna Brzozowska |
| author_sort | Hubert Bochenek |
| collection | DOAJ |
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Introduction and purpose: aa Chronic coronary artery disease (CAD) is a prevalent condition affecting millions of people worldwide, significantly reducing quality of life and increasing the risk of myocardial infarction (MI). Percutaneous coronary intervention (PCI), often combined with stent implantation, is a cornerstone of CAD treatment. However, it induces a prothrombotic state, necessitating dual antiplatelet therapy (DAPT) to mitigate the risk of thrombosis and MI. Despite its established role, the optimal duration and specific composition of DAPT still remain under investigation. This article aims to summarise current knowledge on DAPT and highlight gaps requiring further research.
Description of the state of knowledge: DAPT typically involves acetylsalicylic acid (ASA) 75 mg and clopidogrel 75 mg for 6 months after PCI. While this is effective in reducing thrombotic events, it also increases bleeding risk. Current European Society of Cardiology (ESC) guidelines recommend tailoring DAPT duration and composition based on individual patient risk factors for bleeding and ischemia. Alternatives include shortening DAPT to 1–3 months for patients with high bleeding risk or intensifying it with stronger antiplatelet agents like ticagrelor or prasugrel for those at high ischemic risk. However, evidence supporting these alternatives remains limited, and require further investigation. Emerging options, such as vorapaxar, present additional potential, but also require further validation.
Summary: CAD management through PCI relies heavily on effective DAPT. Current strategies emphasize balancing ischemic and bleeding risks in optimising treatment. Although significant progress has been made, optimal DAPT regimens for specific patient groups remain uncertain, particularly in cases of shortened or intensified therapy. Continued research is crucial to refine treatment protocols and improve patient outcomes.
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| format | Article |
| id | doaj-art-9705a3ee97d44de4813ba27dc3373868 |
| institution | Kabale University |
| issn | 2391-8306 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Kazimierz Wielki University |
| record_format | Article |
| series | Journal of Education, Health and Sport |
| spelling | doaj-art-9705a3ee97d44de4813ba27dc33738682025-02-12T08:17:47ZengKazimierz Wielki UniversityJournal of Education, Health and Sport2391-83062025-02-017810.12775/JEHS.2025.78.57718Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with chronic coronary artery disease (CAD) - current state of knowledge and perspective for further researchHubert Bochenek0https://orcid.org/0009-0002-7221-2793Anna Bielicka1https://orcid.org/0009-0002-3461-4812Michał Bzoma2https://orcid.org/0009-0008-9165-8735Julia Gugulska3https://orcid.org/0009-0007-8333-5066Irmina Czerepak4https://orcid.org/0009-0009-9964-3439Marcin Kapij5https://orcid.org/0009-0004-7028-7198Karolina Niewczas6https://orcid.org/0009-0009-5007-0123Adrianna Brzozowska7https://orcid.org/0009-0009-2625-4766Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, PolandNon-public Health Care Facility “Dekamed”, Lipińska 99, 05-200 WołominFaculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, PolandFaculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, PolandFaculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, PolandFaculty of Nursing, University of Applied Sciences in Nysa, Kornela Ujejskiego 12, 48-300 Nysa, PolandFaculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, PolandFaculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland Introduction and purpose: aa Chronic coronary artery disease (CAD) is a prevalent condition affecting millions of people worldwide, significantly reducing quality of life and increasing the risk of myocardial infarction (MI). Percutaneous coronary intervention (PCI), often combined with stent implantation, is a cornerstone of CAD treatment. However, it induces a prothrombotic state, necessitating dual antiplatelet therapy (DAPT) to mitigate the risk of thrombosis and MI. Despite its established role, the optimal duration and specific composition of DAPT still remain under investigation. This article aims to summarise current knowledge on DAPT and highlight gaps requiring further research. Description of the state of knowledge: DAPT typically involves acetylsalicylic acid (ASA) 75 mg and clopidogrel 75 mg for 6 months after PCI. While this is effective in reducing thrombotic events, it also increases bleeding risk. Current European Society of Cardiology (ESC) guidelines recommend tailoring DAPT duration and composition based on individual patient risk factors for bleeding and ischemia. Alternatives include shortening DAPT to 1–3 months for patients with high bleeding risk or intensifying it with stronger antiplatelet agents like ticagrelor or prasugrel for those at high ischemic risk. However, evidence supporting these alternatives remains limited, and require further investigation. Emerging options, such as vorapaxar, present additional potential, but also require further validation. Summary: CAD management through PCI relies heavily on effective DAPT. Current strategies emphasize balancing ischemic and bleeding risks in optimising treatment. Although significant progress has been made, optimal DAPT regimens for specific patient groups remain uncertain, particularly in cases of shortened or intensified therapy. Continued research is crucial to refine treatment protocols and improve patient outcomes. https://apcz.umk.pl/JEHS/article/view/57718Chronic Coronary Artery Disease (CAD)Dual Antiplatelet Therapy (DAPT)Percutaneous Coronary Intervention (PCI)Antiplatelet Medications |
| spellingShingle | Hubert Bochenek Anna Bielicka Michał Bzoma Julia Gugulska Irmina Czerepak Marcin Kapij Karolina Niewczas Adrianna Brzozowska Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with chronic coronary artery disease (CAD) - current state of knowledge and perspective for further research Journal of Education, Health and Sport Chronic Coronary Artery Disease (CAD) Dual Antiplatelet Therapy (DAPT) Percutaneous Coronary Intervention (PCI) Antiplatelet Medications |
| title | Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with chronic coronary artery disease (CAD) - current state of knowledge and perspective for further research |
| title_full | Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with chronic coronary artery disease (CAD) - current state of knowledge and perspective for further research |
| title_fullStr | Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with chronic coronary artery disease (CAD) - current state of knowledge and perspective for further research |
| title_full_unstemmed | Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with chronic coronary artery disease (CAD) - current state of knowledge and perspective for further research |
| title_short | Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients with chronic coronary artery disease (CAD) - current state of knowledge and perspective for further research |
| title_sort | dual antiplatelet therapy dapt after percutaneous coronary intervention pci in patients with chronic coronary artery disease cad current state of knowledge and perspective for further research |
| topic | Chronic Coronary Artery Disease (CAD) Dual Antiplatelet Therapy (DAPT) Percutaneous Coronary Intervention (PCI) Antiplatelet Medications |
| url | https://apcz.umk.pl/JEHS/article/view/57718 |
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