Aspirin-free antiplatelet regimens after PCI: insights from the GLOBAL LEADERS trial and beyond.

Abstract

Historically, aspirin has been the primary treatment for the prevention of ischaemic events in patients with coronary artery disease. For patients undergoing percutaneous coronary intervention (PCI) standard treatment has been 12 months of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel, followed by aspirin monotherapy; however, DAPT is undeniably associated with an increased risk of bleeding. For over a decade novel P2Y12 inhibitors, which have increased specificity, potency, and efficacy have been available, prompting studies which have tested whether these newer agents can be used in aspirin-free antiplatelet regimens to augment clinical benefits in patients post-PCI. Among these studies, the GLOBAL LEADERS trial is the largest by cohort size, and so far has provided a wealth of evidence in a variety of clinical settings and patient groups. This article summarizes the state-of-the-art evidence obtained from the GLOBAL LEADERS and other trials of aspirin-free strategies.

• Authors: Rutao Wang, Sijing Wu, Amr Gamal, Chao Gao, Hironori Hara, Hideyuki Kawashima, Masafumi Ono, Robert-Jan van Geuns, Pascal Vranckx, Stephan Windecker, Yoshinobu Onuma, Patrick W Serruys, Scot Garg
• Journal: European heart journal. Cardiovascular pharmacotherapy (Eur Heart J Cardiovasc Pharmacother) Vol. 7 Issue 6 Pg. 547-556 (11 03 2021) ISSN: 2055-6845 [Electronic] England
• PMID: 33930107 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

Chemical References

• Platelet Aggregation Inhibitors
• Clopidogrel
• Aspirin

Topics

• Aspirin (therapeutic use)
• Clinical Trials as Topic
• Clopidogrel (therapeutic use)
• Dual Anti-Platelet Therapy (adverse effects, methods)
• Humans
• Percutaneous Coronary Intervention
• Platelet Aggregation Inhibitors (therapeutic use)