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.
Bittl JA, Bates ER, Kaul S. Extended Dual Antiplatelet Therapy in Patients With Prior Myocardial Infarction. JAMA Cardiol. 2016;1(6):629–630. doi:10.1001/jamacardio.2016.2252
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