Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology 2023 Focused Update of the Guidelines for the Use of Antiplatelet Therapy

Antiplatelet therapy (APT) is the foundation of treatment and prevention of atherothrombotic events in patients with atherosclerotic cardiovascular disease. Selecting the optimal APT strategies to reduce major adverse cardiovascular events, while balancing bleeding risk, requires ongoing review of clinical trials. Appended, the focused up- date of the Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology guidelines for the use of APT provides rec- ommendations on the following topics: specialIntscript use of acetylsalicylic acid in primary prevention of atherosclerotic cardiovascular disease; specialIntscript dual APT (DAPT) duration after percutaneous coronary intervention (PCI) in patients at high bleeding risk; specialIntscript potent DAPT (P2Y12 inhibitor) choice in patients who present with an acute coronary syndrome (ACS) and possible DAPT de-escalation strategies after PCI; specialIntscript choice and duration of DAPT in ACS patients who are medically treated without revascularization; specialIntscript pretreatment with DAPT (P2Y12 inhibitor) before elective or nonelective coronary angiography; specialIntscript perioperative and longer -term APT management in patients who require coronary artery bypass grafting surgery; and specialIntscript use of APT in patients with atrial fibrillation who require oral anticoagulation after PCI or medically managed ACS. These recommendations are all on the basis of sys- tematic reviews and meta -analyses conducted as part of the devel- opment of these guidelines, provided in the Supplementary Material.