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Impact of Coronary Lesion Complexity in Percutaneous Coronary Intervention: One-Year Outcomes From the Large, Multicentre e-Ultimaster Registry The Prognostic Significance of Periprocedural Infarction in the Era of Potent Antithrombotic Therapy: The PRAGUE-18 Substudy A Test in Context: E/A and E/e' to Assess Diastolic Dysfunction and LV Filling Pressure Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction Selection of stenting approach for coronary bifurcation lesions Percutaneous coronary intervention for coronary bifurcation disease: 11th consensus document from the European Bifurcation Club Genetic dysregulation of endothelin-1 is implicated in coronary microvascular dysfunction Linking Spontaneous Coronary Artery Dissection, Cervical Artery Dissection, and Fibromuscular Dysplasia: Heart, Brain, and Kidneys Comparative Effectiveness of β-Blocker Use Beyond 3 Years After Myocardial Infarction and Long-Term Outcomes Among Elderly Patients Open sesame technique in percutaneous coronary intervention for ST-elevation myocardial infarction

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.