Systematic review of the clinical impact of dual antiplatelet therapy discontinuation after acute coronary syndromes

Abstract

Results from our systematic literature review generally support the benefit of longer-term dual antiplatelet therapy after acute coronary syndromes; however, further research is needed to determine the optimal length of dual antiplatelet therapy in patients after acute coronary syndrome, ideally using prospective studies.

Preventing recurrent events in survivors of acute coronary syndromes in Australia: consensus recommendations using the Delphi process

“…Although a subset of patients need earlier discontinuation of DAPT (e.g. patients requiring long-term anticoagulation therapy for conditions such as atrial fibrillation or mechanical heart valves), early discontinuation is a recognized risk for recurrent events 33 , and efforts should be directed to ensure that all other patients understand the benefits of therapy and complete a minimum of 12 months of DAPT.…”

Non-ST elevation acute coronary syndromes: timing and selection of early invasive management, ECG monitoring need, DAPT duration, pathogenesis of recurrence and beware of delirium in the intensive/acute cardiac care unit!

“…A systematic review suggests that prolongation of DAPT therapy beyond the standard 12 months period after an acute coronary syndrome may be beneficial but we need more evidence on the optimal duration and on which patients may benefit. 6…”

“…A systematic review suggests that prolongation of DAPT therapy beyond the standard 12 months period after an acute coronary syndrome may be beneficial but we need more evidence on the optimal duration and on which patients may benefit. 6 The electrocardiogram is one of the cornerstones in the diagnosis and follow-up of patients with an acute coronary syndrome. Some NSTE-ACS patients develop a giant T wave inversion and an extreme QT prolongation when pain free in the subacute phase.…”