Juan J Rodriguez1,2, Luis E Baron1,3, Oscar C Munoz4, Jonathan J Diaz2. 1. Texas Tech University Health Sciences Center, El paso, TX, USA. 2. Facultad de Medicina, Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia. 3. Facultad de Medicina, Universidad de Boyaca, Tunja, Colombia. 4. Texas Tech University Health Sciences Center, El paso, TX, USA. omunoz1968@hotmail.com.
Abstract
PURPOSE OF REVIEW: The role of monotherapy with a P2Y12 inhibitor for secondary prevention of cardiovascular diseases has been assessed in several randomized trials. In this article, we summarize the evidence regarding P2Y12 monotherapy for secondary prevention in each one of the major vascular territories. RECENT FINDINGS: Available data including a large recent meta-analysis show no differences in terms of all-cause death, vascular death, stroke, and a minor difference of the risk of myocardial infarction with P2Y12 monotherapy as compared to dual antiplatelet therapy. Overall, mono antiplatelet therapy with aspirin and the P2Y12 inhibitors appear similar in efficacy. However, there are clinical conditions that may suggest one drug regimen over another in secondary prevention. The risk of bleeding must always be weighed in each patient individually for the optimal choice of the antiplatelet regimen.
PURPOSE OF REVIEW: The role of monotherapy with a P2Y12 inhibitor for secondary prevention of cardiovascular diseases has been assessed in several randomized trials. In this article, we summarize the evidence regarding P2Y12 monotherapy for secondary prevention in each one of the major vascular territories. RECENT FINDINGS: Available data including a large recent meta-analysis show no differences in terms of all-cause death, vascular death, stroke, and a minor difference of the risk of myocardial infarction with P2Y12 monotherapy as compared to dual antiplatelet therapy. Overall, mono antiplatelet therapy with aspirin and the P2Y12 inhibitors appear similar in efficacy. However, there are clinical conditions that may suggest one drug regimen over another in secondary prevention. The risk of bleeding must always be weighed in each patient individually for the optimal choice of the antiplatelet regimen.
Authors: Roxana Mehran; Usman Baber; Samin K Sharma; David J Cohen; Dominick J Angiolillo; Carlo Briguori; Jin Y Cha; Timothy Collier; George Dangas; Dariusz Dudek; Vladimír Džavík; Javier Escaned; Robert Gil; Paul Gurbel; Christian W Hamm; Timothy Henry; Kurt Huber; Adnan Kastrati; Upendra Kaul; Ran Kornowski; Mitchell Krucoff; Vijay Kunadian; Steven O Marx; Shamir R Mehta; David Moliterno; E Magnus Ohman; Keith Oldroyd; Gennaro Sardella; Samantha Sartori; Richard Shlofmitz; P Gabriel Steg; Giora Weisz; Bernhard Witzenbichler; Ya-Ling Han; Stuart Pocock; C Michael Gibson Journal: N Engl J Med Date: 2019-09-26 Impact factor: 91.245