|
|
| (65 intermediate revisions by 2 users not shown) |
| Line 1: |
Line 1: |
| ==Overview==
| |
|
| |
|
| Dual antiplatelet therapy (or DAPT) refers to the combination of [[aspirin]] and a P2Y12 receptor antagonist. DAPT is approved for [[SIHD]] and interventions for [[ACS]], such as stent placement following [[PCI]] or [[CABG]]. The duration of treatment with DAPT for each of these categories differs and guidelines for treatment have been updated in the ''2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease''. Much of the studies done on DAPT compared the use of different types of P2Y12 receptor antagonists, the dosage of drugs, as well as the duration of treatment. The current consensus is that the use of DAPT is associated with decreased risk of [[stent thrombosis]], [[MI]] and [[stroke]]. However, the benefits of treatment should be weighed against the increased risk of major bleeding in certain patient populations.
| |
|
| |
| ==Types and Dosage of Drugs==
| |
|
| |
| ===Aspirin===
| |
| [[Aspirin]] 81 mg once daily (range 75-100 mg) is used in all patients with [[SIHD]], stent placement following [[PCI]] or [[CABG]]. The use of [[aspirin]] should be continued indefinitely.
| |
|
| |
| ===P2Y12 Inhibitors===
| |
| There are several P2Y12 inhibitors currently on the market and they are given in the following doses:
| |
| *[[Clopidogrel]]: 75 mg once daily
| |
| *[[Ticagrelor]]: 90 mg once daily
| |
| *[[Prasugrel]]: 10 mg once daily
| |
|
| |
| The drug of choice and duration of treatment depends on the medical condition and current recommendations.
| |
|
| |
| ==Indications==
| |
| *[[Unstable angina/NSTEMI Antiplatelet therapy recommendations#2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease (Updating the 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes (DO NOT EDIT))|Recommendations for Unstable Angina/ NSTEMI Treated with Medical Therapy Alone]]
| |
| *[[ST elevation myocardial infarction anticoagulant and antithrombotic therapy#2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease|Recommendations for STEMI Treated with Medical Therapy Alone]]
| |
| *[[Unstable angina / non ST elevation myocardial infarction recommendations for CABG#2016 ACC/AHA guideline focused update on duration of antiplatelet therapy in patients with coronary artery disease|Unstable angina / non ST elevation myocardial infarction recommendations for CABG]]
| |
| *[[ST elevation myocardial infarction coronary artery bypass grafting#2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease|ST elevation myocardial infarction coronary artery bypass grafting]]
| |
| *[[Pharmacotherapy to Support PCI#2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease|Pharmacotherapy to Support PCI]]
| |
| *[[Chronic stable angina revascularization adjunctive pharmacotherapy for percutaneous coronary intervention#2016 ACC/AHA Guideline focused update on duration of dual antiplatelet therapy (DAPT) in Patients with coronary artery disease|Chronic stable angina revascularization adjunctive pharmacotherapy for percutaneous coronary intervention]]
| |