P2Y12 inhibitor monotherapy in patients undergoing percutaneous coronary intervention

Davide Capodanno, Usman Baber, Deepak L. Bhatt, Jean Philippe Collet, George Dangas, Francesco Franchi, C. Michael Gibson, Hyeon Cheol Gwon, Adnan Kastrati, Takeshi Kimura, Pedro A. Lemos, Renato D. Lopes, Roxana Mehran, Michelle L. O’Donoghue, Sunil V. Rao, Fabiana Rollini, Patrick W. Serruys, Philippe G. Steg, Robert F. Storey, Marco ValgimigliPascal Vranckx, Hirotoshi Watanabe, Stephan Windecker, Dominick J. Angiolillo

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations

Abstract

For 20 years, dual antiplatelet therapy (DAPT), consisting of the combination of aspirin and a platelet P2Y12 receptor inhibitor, has been the gold standard of antithrombotic pharmacology after percutaneous coronary intervention (PCI). In the past 5 years, several investigations have challenged this paradigm by testing the efficacy and safety of P2Y12 inhibitor monotherapy (that is, without aspirin) following a short course of DAPT. Collectively, these studies suggested a reduction in the risk of major bleeding and no significant increase in thrombotic or ischaemic events compared with guideline-recommended DAPT. Current recommendations are evolving to inform clinical practice on the ideal candidates for P2Y12 inhibitor monotherapy after PCI. Generalizing the results of studies of P2Y12 inhibitor monotherapy requires a thorough understanding of their design, populations, interventions, comparators and results. In this Review, we provide an up-to-date overview on the use of P2Y12 inhibitor monotherapy after PCI, including supporting pharmacodynamic and clinical evidence, practical recommendations and future directions.

Original languageEnglish
Pages (from-to)829-844
Number of pages16
JournalNature Reviews Cardiology
Volume19
Issue number12
DOIs
StatePublished - Dec 2022

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