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In primary prevention (patients with cardiovascular risk factors but no documented events, symptoms or angiographic disease), there is little evidence of benefit of any antiplatelet therapy, and such therapy carries the risk of excess bleeding. Where there is documented disease (secondary prevention), stable patients benefit from long\u2010term antiplatelet monotherapy, aspirin being first choice in those with coronary heart disease and clopidogrel in those with cerebrovascular disease; moreover, recent evidence shows that low\u2010dose rivaroxaban in combination with aspirin confers added benefit, in patients with stable cardiovascular and peripheral arterial disease. In patients with acute cerebrovascular disease, aspirin combined with clopidogrel reduces subsequent risk, while in acute coronary syndrome, dual antiplatelet therapy comprising aspirin and a P2Y\n                    <jats:sub>12<\/jats:sub>\n                    inhibitor (clopidogrel, prasugrel or ticagrelor) confers greater protection than aspirin monotherapy, with prasugrel and ticagrelor offering greater antiplatelet efficacy with faster onset of action than clopidogrel. Although greater antiplatelet efficacy is advantageous in preventing thrombotic events, this must be tempered by increased risk of bleeding, which may be a particular issue in certain patient groups, as will be discussed. We will also discuss possible future approaches to personalisation of antiplatelet therapy.\n                  <\/jats:p>","DOI":"10.1111\/bcp.15221","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T02:24:51Z","timestamp":1641781491000},"page":"2686-2699","source":"Crossref","is-referenced-by-count":88,"title":["Antiplatelet therapy in cardiovascular disease: Current status and future directions"],"prefix":"10.1111","volume":"88","author":[{"given":"Gabriella","family":"Passacquale","sequence":"first","affiliation":[{"name":"School of Cardiovascular Medicine and Sciences, British Heart Foundation Centre of Research Excellence King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Sharma","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Research, Royal Holloway University of London  Egham Surrey 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