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Dapagliflozin for treating chronic heart failure with reduced ejection fraction Switching of Oral Anticoagulation Therapy After PCI in Patients With Atrial Fibrillation: The RE-DUAL PCI Trial Subanalysis A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenosis Impact of epicardial adipose tissue on cardiovascular haemodynamics, metabolic profile, and prognosis in heart failure Association of Circulating Monocyte Chemoattractant Protein-1 Levels With Cardiovascular Mortality: A Meta-analysis of Population-Based Studies Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement Impact of Lesion Preparation Strategies on Outcomes of Left Main PCI: The EXCEL Trial Risk Stratification in PAH INTERMACS Profiles and Outcomes Among Non–Inotrope-Dependent Outpatients With Heart Failure and Reduced Ejection Fraction The Year in Cardiovascular Medicine 2020: Valvular Heart Disease: Discussing the Year in Cardiovascular Medicine for 2020 in the field of valvular heart disease is Professor Helmut Baumgartner and Dr Javier Bermejo. Mark Nicholls reports

Review ArticleVolume 72, Issue 23 Part A, December 2018

JOURNAL:J Am Coll Cardiol. Article Link

ACC/AHA Versus ESC Guidelines on Dual Antiplatelet Therapy JACC Guideline Comparison: JACC State-of-the-Art Review

D Capodanno, F Alfonso, GN Levine et al. Keywords: antiplatelet; bleeding; stent; thrombosis; ACC/AHA Versus ESC Guidelines

ABSTRACT


Dual antiplatelet therapy (DAPT) is the cornerstone of pharmacological treatment aimed at preventing the atherothrombotic complications in patients with a variety of coronary artery disease (CAD) manifestations. Prescribers of DAPT are confronted with a number of challenges that include selecting the appropriate P2Y12 inhibitor and determining the optimal duration of DAPT with the scope of minimizing the risk of ischemic and bleeding complications in light of each patient’s clinical characteristic and circumstance. Recently, a guideline writing committee from the American College of Cardiology/American Heart Association (ACC/AHA) and a task force from the European Society of Cardiology (ESC) released their respective focused update recommendations on “Duration of DAPT in Patients with CAD” (ACC/AHA) and “DAPT in CAD” (ESC). This paper aims to review the ACC/AHA and ESC updates for DAPT to delineate common domains, consistent messages, and differences in recommended management strategies across the Atlantic.