Dual antiplatelet therapy (DAPT) is an important strategy for reducing cardiovascular events (CV) after an acute coronary syndrome (ACS). Elderly patients undergoing DAPT have a higher risk of bleeding than younger patients for a variety of reasons. Stratification of thrombotic/hemorrhagic risk is mandatory in order to decide on the type and duration of DAPT. The percentage of patients ≥ 75 years represented in clinical trials is not large, so very often elderly people are prescribed treatment protocols only experimented on younger patients with a lower hemorrhagic risk. However, even in patients aged ≥ 75 treated with invasive or conservative therapy, after an ACS, a DAPT with aspirin 80-100 mg/day plus a P2Y12 receptor inhibitor for 12 months is recommended. In elderly patients, DAPT should be considered a dynamic process that can be modified over time based on the patient's clinical conditions, or any other necessities (non-procrastinating surgical interventions, comorbid-like effects that can increase hemorrhagic risk). In patients with moderate-high or very high hemorrhagic risk, DAPT treatment should last less than 12 months. A prolongation of DAPT beyond 12 months in this setting is limited to a very low percentage of patients, after careful assessment of ischemic/hemorrhagic profile.
Antiplatelet therapy in elderly patients with acute coronary syndrome. between scientific evidence and future perspectives / Barillà, Francesco; Torromeo, Concetta; Iorio, Riccardo; Porco, Luigina; Paravati, Vincenzo; Gaudio, Carlo. - In: MONALDI ARCHIVES FOR CHEST DISEASE. - ISSN 1122-0643. - ELETTRONICO. - 88:2(2018), pp. 28-31. [10.4081/monaldi.2018.952]
Titolo: | Antiplatelet therapy in elderly patients with acute coronary syndrome. between scientific evidence and future perspectives | |
Autori: | ||
Data di pubblicazione: | 2018 | |
Rivista: | ||
Citazione: | Antiplatelet therapy in elderly patients with acute coronary syndrome. between scientific evidence and future perspectives / Barillà, Francesco; Torromeo, Concetta; Iorio, Riccardo; Porco, Luigina; Paravati, Vincenzo; Gaudio, Carlo. - In: MONALDI ARCHIVES FOR CHEST DISEASE. - ISSN 1122-0643. - ELETTRONICO. - 88:2(2018), pp. 28-31. [10.4081/monaldi.2018.952] | |
Handle: | http://hdl.handle.net/11573/1138191 | |
Appartiene alla tipologia: | 01a Articolo in rivista |
File allegati a questo prodotto
File | Note | Tipologia | Licenza | |
---|---|---|---|---|
Barillà_Antiplatelet_2018.pdf | Versione editoriale (versione pubblicata con il layout dell'editore) | ![]() | Open Access Visualizza/Apri |