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Safety and feasibility of robotic percutaneous coronary intervention: PRECISE (Percutaneous Robotically-Enhanced Coronary Intervention) Study Influence of LDL-Cholesterol Lowering on Cardiovascular Outcomes in Patients With Diabetes Mellitus Undergoing Coronary Revascularization Comparative Accuracy of Focused Cardiac Ultrasonography and Clinical Examination for Left Ventricular Dysfunction and Valvular Heart Disease: A Systematic Review and Meta-analysis Utilization and programming of an automatic MRI recognition feature for cardiac rhythm management devices Cardiorespiratory Fitness and Mortality in Healthy Men and Women The optimal duration of dual antiplatelet therapy after coronary stent implantation: to go too far is as bad as to fall short Cholesterol-Lowering Agents Impact of Statins on Cardiovascular Outcomes Following Coronary Artery Calcium Scoring Short-term and long-term clinical outcomes of rotational atherectomy in resistant chronic total occlusion Association of CYP2C19 Loss-of-Function Alleles with Major Adverse Cardiovascular Events of Clopidogrel in Stable Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention: Meta-analysis

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.