The dogma of aspirin: a critical review of evidence on the best monotherapy after dual antiplatelet therapy

Thrombosis Journal
Hernan Polo FrizClaudio Cimminiello

Abstract

Dual antiplatelet therapy based on the combination of an adenosine diphosphate (ADP)-receptor antagonist plus aspirin has demonstrated to be more effective in reducing the rate of major ischemic vascular events compared to aspirin monotherapy in some clinical settings. The current controversy on the duration of dual antiplatelet therapy should not conceal another major issue: the choice of the more appropriate antiplatelet monotherapy after the dual treatment phase. The aim of this article is to critically analyze the available evidence in this topic. Data from studies like CAPRIE, MATCH, PROFESS, CHANCE, DAPT and others, raise questions as why antiplatelet monotherapy after the dual phase should only be based on aspirin, in spite of a lack of evidence surprisingly not highlighted by key opinion leaders and experts. We conclude that, whether ADP-receptor antagonist rather than aspirin may be proposed as monotherapy seems not only have no answer but also not place in the current specialists' analysis, as if a dogmatic approach were prevalent. Perhaps the time for an open debate on these topics is ripe.

References

Jun 27, 2000·Scandinavian Journal of Gastroenterology·F T ForkF Lindgärde
Aug 25, 2001·The New England Journal of Medicine·S YusufUNKNOWN Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Aug 25, 2001·Lancet·S R MehtaUNKNOWN Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) Investigators
Nov 19, 2002·JAMA : the Journal of the American Medical Association·Steven R SteinhublUNKNOWN CREDO Investigators. Clopidogrel for the Reduction of Events During Observation
Jun 11, 2003·American Heart Journal·Steven Steinhubl, Peter Berger
Nov 1, 2003·Thrombosis Research·J van Gijn, A Algra
Mar 11, 2005·The New England Journal of Medicine·Marc S SabatineUNKNOWN CLARITY-TIMI 28 Investigators
Sep 7, 2005·JAMA : the Journal of the American Medical Association·Marc S SabatineUNKNOWN Clopidogrel as Adjunctive Reperfusion Therapy (CLARITY)-Thrombolysis in Myocardial Infarction (TIMI) 28 Investigators
Nov 8, 2005·Lancet·Z M ChenUNKNOWN COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group
Mar 15, 2006·The New England Journal of Medicine·Deepak L BhattUNKNOWN CHARISMA Investigators
Aug 30, 2008·The New England Journal of Medicine·Ralph L SaccoUNKNOWN PRoFESS Study Group
May 14, 2009·JAMA : the Journal of the American Medical Association·Jeffrey S BergerWilliam R Hiatt
Aug 2, 2011·European Heart Journal·Michael A Gaglia, Ron Waksman
Oct 25, 2011·European Heart Journal·Carlo PatronoFreek Verheugt
Aug 31, 2012·The New England Journal of Medicine·UNKNOWN SPS3 InvestigatorsLesly A Pearce
Jun 28, 2013·The New England Journal of Medicine·Yongjun WangUNKNOWN CHANCE Investigators
Oct 4, 2013·The New England Journal of Medicine·Yilong WangYongjun Wang
Nov 18, 2014·The New England Journal of Medicine·Laura MauriUNKNOWN DAPT Study Investigators

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Citations

Jun 12, 2019·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·D A SychevI M Mickhalevich

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Methods Mentioned

BETA
percutaneous transluminal angioplasty

Clinical Trials Mentioned

NCT01813435

Software Mentioned

PROFESS
MATCH

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