Extended dual antiplatelet therapy for Asian patients with acute coronary syndrome: expert recommendations

Internal Medicine Journal
Walter W C ChenTony C K Au Yeong

Abstract

Recently, new evidence from large scale trials and updated guidelines have emerged on the risks and benefits of extended dual antiplatelet therapy (DAPT) for patients with acute coronary syndrome (ACS). To discuss, clarify and advise on the application of the evidences and guidelines on individual patient selection for extended DAPT, with regard to balancing risk factors, particularly in Asian populations. A total of 14 local cardiologists from Hong Kong with extensive experience in cardiology and cardiac interventions convened in a series of 3 advisory board meetings from October 2016 to September 2017, which included reviews of new evidence in the literature and discussions of the latest clinical trends, using an anonymous, electronic voting system for arriving at consensuses. Recommendations were produced for the following nine risk factors: old age (>65), chronic kidney disease (CKD), diabetes mellitus (DM), recurrent myocardial infarction (MI), multi-vessel disease (MVD), multiple stents, bioresorbable vascular scaffold (BVS) stent, left main stenting and peripheral artery disease (PAD). Strong ischaemic risk factors include DM, recurrent MI, MVD and/or >3 stents; less-strong ischaemic factors include CKD, left main stenti...Continue Reading

References

Oct 19, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Daisaku NakataniUNKNOWN Osaka Acute Coronary Insufficiency Study (OACIS) Investigators
Nov 18, 2014·The New England Journal of Medicine·Laura MauriUNKNOWN DAPT Study Investigators
Mar 17, 2015·The New England Journal of Medicine·Marc P BonacaUNKNOWN PEGASUS-TIMI 54 Steering Committee and Investigators
Apr 17, 2017·Journal of the American College of Cardiology·Sabato SorrentinoGeorge D Dangas
Aug 10, 2017·Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University·Guozhen CuiHao Chen
Jul 1, 2016·European Heart Journal. Quality of Care & Clinical Outcomes·Eleni RapsomanikiHarry Hemingway

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