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From the JAMA Network
July 11, 2017

Balancing Ischemic and Bleeding Risks of Prolonged Dual Antiplatelet Therapy

Author Affiliations
  • 1Section of Cardiology, Baylor College of Medicine, Houston, Texas
JAMA. 2017;318(2):194-195. doi:10.1001/jama.2017.6698

Dual antiplatelet therapy (DAPT) combines aspirin with a P1Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) to decrease the risk of coronary thrombosis. Quiz Ref IDCompared with antiplatelet therapy with aspirin alone, DAPT after a myocardial infarction (MI) or percutaneous coronary intervention (PCI) reduces the risk of spontaneous MI and coronary stent thrombosis (Audio).1 However, the addition, intensification, or prolongation of antiplatelet therapy necessitates a trade-off between decreasing ischemic risk and increasing bleeding risk.1 In addition to this trade-off, consideration also must be given to the implications of ischemic or bleeding events, how patients are selected for treatment with DAPT and its duration, and what can be done to reduce bleeding risk.