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Colegio de Medicina Interna de México.

2023, Number 3

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Med Int Mex 2023; 39 (3)

Dual antiplatelet therapy: 'The evidence for the evident'

Muñoz-Rossi FA, Ricardo-Ossio GP, Orozco-Molina PA, Puentes-Rodríguez CJ, Camargo-Vargas DA

Language: Spanish
References: 40
Page: 495-503
PDF size: 219.85 Kb.


ABSTRACT

It is clear a strong role of dual antiplatelet therapy in reducing recurrent major adverse cardiovascular events in patients with acute and chronic coronary syndrome, with a declining trend in the use of this therapy in optimal duration and time recently demonstrated in the pretreatment scenario of coronary syndrome, generating controversy in the current role given by the ESC 2020 guidelines, based on a risk profile and management strategy according to the risk of bleeding, in turn as the paradigm shift in antithrombotic therapy with the inclusion of direct oral anticoagulants in the extended therapy setting. Remembering the indication for dual anti-platelet therapy/ oral anticoagulation in acute coronary syndrome and atrial fibrillation, the recommendation for an increasingly shorter duration of triple therapy, with the appropriate choice of antiaggregant according to the patient’s risk. No less important are the recent advances in the use of dual anti-platelet therapy in patients with cerebrovascular attack and an increasingly relevant role in the transitory or mild scenario (NIHSS 3), given the evidence of studies such as CHANCE and POINT. This article is intended to provide a review of the current evidence for dual antiplatelet therapy and its utility in different settings in secondary prevention.


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