Dual antiplatelet therapy acetylsalicylic acid dosing : a review of the clinical effectiveness and harms

Acute coronary syndromes (ACS) continue to be the worldwide leading cause of adult mortality and morbidity.1 Patients with ACS or stable angina are commonly treated with percutaneous coronary intervention (PCI) and stenting to slow coronary artery disease progression and prevent major cardiac events...

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Corporate Author: Canadian Agency for Drugs and Technologies in Health
Format: eBook
Language:English
Published: Ottawa (ON) Canadian Agency for Drugs and Technologies in Health 2017, 14 March 2017
Series:Rapid response report: summary with critical appraisal
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Summary:Acute coronary syndromes (ACS) continue to be the worldwide leading cause of adult mortality and morbidity.1 Patients with ACS or stable angina are commonly treated with percutaneous coronary intervention (PCI) and stenting to slow coronary artery disease progression and prevent major cardiac events.2 The risks of PCI with stenting include thrombotic complications of acute closure and stent thrombosis. Antiplatelet therapeutics have become an integral part of this management approach to prevent activation of the thrombotic cascade and these subsequent complications.1-3 Dual antiplatelet therapy (DAPT) is the most common therapeutic option for patients following PCI.1 DAPT consists of aspirin (acetylsalicylic acid, ASA) in combination with clopidogrel (an irreversible P2Y12 inhibitor), prasugrel (an irreversible P2Y12 inhibitor), or ticagrelor (a reversible P2Y12 receptor antagonist).1 In particular, ASA with clopidogrel has demonstrated prevention of thrombotic events in patients undergoing PCI and has represented the standard of care for many years.3 ASA itself has been a cornerstone of antiplatelet therapy for many years offering cardioprotective effects through irreversible inhibition of cycloxygenase-1 and subsequent downstream reduction of thrombus formation.4 Clinically effective and safe DAPT dosing requires a balance between thrombotic risk with inadequate inhibition and bleeding risk with potent inhibition for this patient population.1 A previously published CADTH technology report, from November 2010, reviewed the evidence for different ASA doses as part of DAPT as one objective.5 The purpose of this report is to retrieve and review current existing evidence on the clinical effectiveness and safety of a range of ASA doses as a component of DAPT for patients following PCI with stenting
Item Description:"CADTH Rapid Response Service."
Physical Description:1 online resource (1 PDF file (18 pages)) illustrations