{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:37:00Z","timestamp":1781825820632,"version":"3.54.5"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"DOI":"10.13039\/100005205","name":"Janssen Research and Development","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100005205","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>\n            Background\u2003To date, there are no data on switching to dual pathway inhibition (DPI) patients who have completed a guideline-recommended dual antiplatelet therapy (DAPT) regimen.<\/jats:p><jats:p>\n            Objectives\u2003To assess the feasibility of switching from DAPT to DPI and to compare the pharmacodynamic (PD) profiles of these treatments.<\/jats:p><jats:p>\n            Methods\u2003This was a prospective, randomized, PD study conducted in 90 patients with chronic coronary syndrome (CCS) on DAPT with aspirin (81\u2009mg\/qd) plus a P2Y12 inhibitor (clopidogrel [75\u2009mg\/qd; n\u2009=\u200930], ticagrelor [90\u2009mg\/bid; n\u2009=\u200930], or prasugrel [10\u2009mg\/qd; n\u2009=\u200930]). Patients in each cohort were randomized to maintain DAPT or switch to DPI (aspirin 81\u2009mg\/qd plus rivaroxaban 2.5\u2009mg\/bid). PD assessments included: VerifyNow P2Y12 reaction units; light transmittance aggregometry following stimuli with adenosine diphosphate (ADP), tissue factor (TF), and a combination of collagen, ADP, and TF (maximum platelet aggregation %); thrombin generation (TG). Assays were performed at baseline and 30 days postrandomization.<\/jats:p><jats:p>\n            Results\u2003Switching from DAPT to DPI occurred without major side effects. DAPT was associated with enhanced P2Y12 inhibition, while DPI with reduced TG. Platelet-mediated global thrombogenicity (primary endpoint) showed no differences between DAPT and DPI in the ticagrelor (14.5% [0.0\u201363.0] vs. 20.0% [0.0\u201370.0]; p\u2009=\u20090.477) and prasugrel (20.0% [0.0\u201366.0] vs. 4.0% [0.0\u201370.0]; p\u2009=\u20090.482), but not clopidogrel (27.0% [0.0\u201368.0] vs. 53.0% [0.0\u201381.0]; p\u2009=\u20090.011), cohorts.<\/jats:p><jats:p>\n            Conclusion\u2003In patients with CCS, switching from different DAPT regimens to DPI was feasible, showing enhanced P2Y12 inhibition with DAPT and reduced TG with DPI, with no differences in platelet-mediated global thrombogenicity between DPI and ticagrelor- and prasugrel-, but not clopidogrel-, based DAPT.<\/jats:p><jats:p>\n            Clinical Trial Registration\u2003http:\/\/www.clinicaltrials.gov Unique Identifier: NCT04006288.<\/jats:p>","DOI":"10.1055\/a-2098-6639","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T23:10:04Z","timestamp":1684969804000},"page":"263-273","source":"Crossref","is-referenced-by-count":9,"title":["Switching from Dual Antiplatelet Therapy with Aspirin Plus a P2Y12 Inhibitor to Dual Pathway Inhibition with Aspirin Plus Vascular-Dose Rivaroxaban: The Switching Anti-Platelet and Anti-Coagulant Therapy (SWAP-AC) Study"],"prefix":"10.1055","volume":"124","clinical-trial-number":[{"clinical-trial-number":"nct04006288","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9567-3253","authenticated-orcid":false,"given":"Luis","family":"Ortega-Paz","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Franchi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Rollini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3909-182X","authenticated-orcid":false,"given":"Mattia","family":"Galli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"},{"name":"Departmet of Cardiology, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latonya","family":"Been","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghussan","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awss","family":"Shalhoub","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Ossi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rivas","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres M.","family":"Pineda","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siva","family":"Suryadevara","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Soffer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M.","family":"Zenni","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa K.","family":"Jennings","sequence":"additional","affiliation":[{"name":"MLM Medical Labs, LLC, Memphis, Tennessee, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8451-2131","authenticated-orcid":false,"given":"Dominick J.","family":"Angiolillo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Florida College of Medicine, 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