P2Y12 Inhibitor Monotherapy after Percutaneous Coronary Intervention: Is It Safe to Abandon Aspirin?

被引：10

作者：

Feng, Wen-Han ^{[1
]}

Hsieh, I-Chang ^{[2
]}

Li, Yi-Heng ^{[3
]}

机构：

[1] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Kaohsiung Municipal Ta Tung Hosp, Dept Internal Med, Kaohsiung, Taiwan

[2] Chang Gung Univ, Chang Gung Mem Hosp, Coll Med, Dept Internal Med, Taoyuan, Taiwan

[3] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Internal Med, Tainan, Taiwan

来源：

ACTA CARDIOLOGICA SINICA | 2021年 / 37卷 / 01期

关键词：

Coronary artery disease (CAD); Monotherapy; Percutaneous intervention; DUAL-ANTIPLATELET THERAPY; DRUG-ELUTING STENTS; CARDIOVASCULAR EVENTS; CLOPIDOGREL; DURATION; RECEPTOR; TICAGRELOR; STRATEGY; TRIAL;

D O I：

10.6515/ACS.202101_37(1).20200806A

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor for 6-12 months is the current standard treatment for patients after percutaneous coronary intervention (PCI). However, the optimal DAPT duration is still under debate. A novel strategy with P2Y12 inhibitor monotherapy after PCI has been proposed recently. This strategy shortens the duration of DAPT to 1 to 3 months, followed by monotherapy with a P2Y12 inhibitor instead of aspirin. It has been tested in several clinical trials with promising results. In this article, we reviewed the relevant clinical trial data and the scientific rationale of P2Y12 inhibitor monotherapy with laboratory evidence of platelet inhibition. An early aspirin-free strategy with P2Y12 inhibitor monotherapy seems feasible in some of the patients after PCI.

引用

页码：1 / 8

页数：8

共 32 条

[1] In the presence of strong P2Y12 receptor blockade, aspirin provides little additional inhibition of platelet aggregation [J].

Armstrong, P. C. J. ;

Leadbeater, P. D. ;

Chan, M. V. ;

Kirkby, N. S. ;

Jakubowski, J. A. ;

Mitchell, J. A. ;

Warner, T. D. .

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2011, 9 (03) :552-561

[2] Reduction of platelet thromboxane A2 production ex vivo and in vivo by clopidogrel therapy [J].

Armstrong, P. C. J. ;

Dhanji, A. -R. A. ;

Tucker, A. T. ;

Mitchell, J. A. ;

Warner, T. D. .

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2010, 8 (03) :613-615

[3] Time-Dependent Associations Between Actionable Bleeding, Coronary Thrombotic Events, and Mortality Following Percutaneous Coronary Intervention Results From the PARIS Registry [J].

Baber, Usman ;

Dangas, George ;

Chandrasekhar, Jaya ;

Sartori, Samantha ;

Steg, Philippe Gabriel ;

Cohen, David J. ;

Giustino, Gennaro ;

Ariti, Cono ;

Witzenbichler, Bernhard ;

Henry, Timothy D. ;

Kini, Annapoorna S. ;

Krucoff, Mitchell W. ;

Gibson, C. Michael ;

Chieffo, Alaide ;

Moliterno, David J. ;

Weisz, Giora ;

Colombo, Antonio ;

Pocock, Stuart ;

Mehran, Roxana .

JACC-CARDIOVASCULAR INTERVENTIONS, 2016, 9 (13) :1349-1357

[4] Antagonism of P2Y12 reduces physiological thromboxane levels [J].

Bhavaraju, Kamala ;

Georgakis, Alexander ;

Jin, Jianguo ;

Gartner, Theodore Kent ;

Tomiyama, Yoshiaki ;

Nurden, Alan ;

Nurden, Paquita ;

Kunapuli, Satya P. .

PLATELETS, 2010, 21 (08) :604-609

[5] Early potent antithrombotic effect with combined aspirin and a loading dose of clopidogrel on experimental arterial thrombogenesis in humans [J].

Cadroy, Y ;

Bossavy, JP ;

Thalamas, C ;

Sagnard, L ;

Sakariassen, K ;

Boneu, B .

CIRCULATION, 2000, 101 (24) :2823-2828

[6] Stent thrombosis late after implantation of first-generation drug-eluting stents - A cause for concern [J].

Camenzind, Edoardo ;

Steg, P. Gabriel ;

Wijns, William .

CIRCULATION, 2007, 115 (11) :1440-1455

[7] Comparison of ticagrelor with clopidogrel in patients with planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study [J].

Cannon, Christopher P. ;

Harrington, Robert A. ;

James, Stefan ;

Ardissino, Diego ;

Becker, Richard C. ;

Emanuelsson, Hakan ;

Husted, Steen ;

Katus, Hugo ;

Keltai, Matyas ;

Khurmi, Nardev S. ;

Kontny, Frederic ;

Lewis, Basil S. ;

Steg, Philippe Gabriel ;

Storey, Robert F. ;

Wojdyla, Daniel ;

Wallentin, Lars .

LANCET, 2010, 375 (9711) :283-293

[8] Aspirin-free strategies in cardiovascular disease and cardioembolic stroke prevention [J].

Capodanno, Davide ;

Mehran, Roxana ;

Valgimigli, Marco ;

Baber, Usman ;

Windecker, Stephan ;

Vranckx, Pascal ;

Dangas, George ;

Rollini, Fabiana ;

Kimura, Takeshi ;

Collet, Jean-Philippe ;

Gibson, C. Michael ;

Steg, Philippe Gabriel ;

Lopes, Renato D. ;

Gwon, Hyeon-Cheol ;

Storey, Robert F. ;

Franchi, Francesco ;

Bhatt, Deepak L. ;

Serruys, Patrick W. ;

Angiolillo, Dominick J. .

NATURE REVIEWS CARDIOLOGY, 2018, 15 (08) :480-496

[9] Three vs Twelve Months of Dual Antiplatelet Therapy After Zotarolimus-Eluting Stents The OPTIMIZE Randomized Trial [J].

Feres, Fausto ;

Costa, Ricardo A. ;

Abizaid, Alexandre ;

Leon, Martin B. ;

Marin-Neto, J. Antonio ;

Botelho, Roberto V. ;

King, Spencer B., III ;

Negoita, Manuela ;

Liu, Minglei ;

de Paula, J. Eduardo T. ;

Mangione, Jose A. ;

Meireles, George X. ;

Castello, Helio J., Jr. ;

Nicolela, Eduardo L., Jr. ;

Perin, Marco A. ;

Devito, Fernando S. ;

Labrunie, Andre ;

Salvadori, Decio, Jr. ;

Gusmao, Marcos ;

Staico, Rodolfo ;

Costa, J. Ribamar ;

de Castro, Juliana P. ;

Abizaid, Andrea S. ;

Bhatt, Deepak L. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 310 (23) :2510-2522

[10] Incidence, Predictors, and Impact of Post-Discharge Bleeding After Percutaneous Coronary Intervention [J].

Genereux, Philippe ;

Giustino, Gennaro ;

Witzenbichler, Bernhard ;

Weisz, Giora ;

Stuckey, Thomas D. ;

Rinaldi, Michael J. ;

Neumann, Franz-Josef ;

Metzger, D. Christopher ;

Henry, Timothy D. ;

Cox, David A. ;

Duffy, Peter L. ;

Mazzaferri, Ernest ;

Yadav, Mayank ;

Francese, Dominic P. ;

Palmerini, Tullio ;

Kirtane, Ajay J. ;

Litherland, Claire ;

Mehran, Roxana ;

Stone, Gregg W. .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2015, 66 (09) :1036-1045

← 1 2 3 4 →