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ACC/AHA Versus ESC Guidelines on Dual Antiplatelet Therapy: JACC Guideline Comparison

J Am Coll Cardiol. 2018 Dec 11;72(23 Pt A):2915-2931. doi: 10.1016/j.jacc.2018.09.057.

Abstract

Dual antiplatelet therapy (DAPT) is the cornerstone of pharmacological treatment aimed at preventing the atherothrombotic complications in patients with a variety of coronary artery disease (CAD) manifestations. Prescribers of DAPT are confronted with a number of challenges that include selecting the appropriate P2Y12 inhibitor and determining the optimal duration of DAPT with the scope of minimizing the risk of ischemic and bleeding complications in light of each patient's clinical characteristic and circumstance. Recently, a guideline writing committee from the American College of Cardiology/American Heart Association (ACC/AHA) and a task force from the European Society of Cardiology (ESC) released their respective focused update recommendations on "Duration of DAPT in Patients with CAD" (ACC/AHA) and "DAPT in CAD" (ESC). This paper aims to review the ACC/AHA and ESC updates for DAPT to delineate common domains, consistent messages, and differences in recommended management strategies across the Atlantic.

Keywords: antiplatelet; bleeding; stent; thrombosis.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Advisory Committees / standards
  • American Heart Association*
  • Cardiology / methods
  • Cardiology / standards*
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / epidemiology
  • Europe / epidemiology
  • Humans
  • Platelet Aggregation Inhibitors / administration & dosage*
  • Practice Guidelines as Topic / standards*
  • Societies, Medical / standards*
  • United States / epidemiology

Substances

  • Platelet Aggregation Inhibitors