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September 2016

Extended Dual Antiplatelet Therapy in Patients With Prior Myocardial Infarction

Author Affiliations
  • 1Interventional Cardiology Section, Munroe Regional Medical Center, Ocala, Florida
  • 2Department of Medicine, University of Michigan Medical Center, Ann Arbor
  • 3Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
JAMA Cardiol. 2016;1(6):629-630. doi:10.1001/jamacardio.2016.2252

Patients with a history of myocardial infarction (MI) have an increased risk of recurrent cardiovascular events, including angina, MI, stroke, and death. It is possible that this risk will be reduced if patients are treated with dual antiplatelet therapy (DAPT) for longer than the recommended course of 12 months.1

The Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared With Placebo on a Background of Aspirin–Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial randomized 21 162 stable patients to 2 doses of ticagrelor (90 mg and 60 mg twice daily) or placebo 1 to 3 years after MI.2 Eligible patients were 50 years and older and had at least 1 additional high-risk feature, ie, were 65 years or older or had a second prior spontaneous MI, multivessel coronary artery disease, diabetes requiring medication, or chronic renal dysfunction.

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