{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T20:42:17Z","timestamp":1772224937201,"version":"3.50.1"},"reference-count":21,"publisher":"Radcliffe Medical Media Ltd","license":[{"start":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T00:00:00Z","timestamp":1582675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/legalcode"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Cardiol"],"abstract":"<jats:p>Dual antiplatelet therapy (DAPT) is integral to the management of coronary artery disease (CAD) but there remains uncertainty as to the optimal approach for balancing an individual\u2019s risk of atherothrombotic events versus their risk of bleeding complications. A myriad of clinical trials have investigated how factors such as antiplatelet selection or duration of treatment can affect outcomes in both stable CAD and acute coronary syndromes. To aid clinicians in the challenge of applying trial findings to the circumstances of individual patients, the American College of Cardiology\/American Heart Association and European Society of Cardiology have released focused updates on prescribing DAPT in CAD. While the two guidelines agree on many issues, there are some differences in the recommendations. This article highlights those differences and provides comment on their aetiology.<\/jats:p>","DOI":"10.15420\/ecr.2019.09","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T14:36:34Z","timestamp":1582900594000},"source":"Crossref","is-referenced-by-count":16,"title":["Dual Antiplatelet Therapy in Coronary Artery Disease: Comparison Between ACC\/AHA 2016 and ESC 2017 Guidelines"],"prefix":"10.15420","volume":"15","author":[{"given":"Christopher N","family":"Floyd","sequence":"first","affiliation":[{"name":"King\u2019s College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, Department of Clinical Pharmacology, London, UK; Biomedical Research Centre, Clinical Research Facility, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6096","published-online":{"date-parts":[[2020,2,26]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Antithrombotic Trialists\u2019 (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009;373:1849\u201360. https:\/\/doi.org\/10.1016\/S0140-6736(09)60503-1; PMID: 19482214.","DOI":"10.1016\/s0140-6736(09)60503-1"},{"key":"ref1","unstructured":"Levine GN, Bates ER, Bittl JA, et al. 2016 ACC\/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2016;68:1082\u2013115. https:\/\/doi.org\/10.1016\/j.jacc.2016.03.513; PMID: 27036918."},{"key":"ref2","unstructured":"Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2018;39:213\u201360. https:\/\/doi.org\/10.1093\/eurheartj\/ehx419; PMID: 28886622."},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Floyd CN, Passacquale G, Ferro A. Comparative pharmacokinetics and pharmacodynamics of platelet adenosine diphosphate receptor antagonists and their clinical implications. Clin Pharmacokinet 2012;51:429\u201342. https:\/\/doi.org\/10.2165\/11630740-000000000-00000; PMID: 22568693.","DOI":"10.2165\/11630740-000000000-00000"},{"key":"ref4","unstructured":"Mauri L, Kereiakes DJ, Yeh RW, et al. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 2014;371:2155\u201366. https:\/\/doi.org\/10.1056\/NEJMoa1409312; PMID: 25399658."},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Yeh RW, Secemsky EA, Kereiakes DJ, et al. Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention. JAMA 2016;315:1735\u201349. https:\/\/doi.org\/10.1001\/jama.2016.3775; PMID: 27022822.","DOI":"10.1001\/jama.2016.3775"},{"key":"ref6","unstructured":"Costa F, van Klaveren D, James S, et al. Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: a pooled analysis of individual-patient datasets from clinical trials. Lancet 2017;389:1025\u201334. https:\/\/doi.org\/10.1016\/S0140-6736(17)30397-5; PMID: 28290994."},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Agewall S, Cattaneo M, Collet JP, et al. Expert position paper on the use of proton pump inhibitors in patients with cardiovascular disease and antithrombotic therapy. Eur Heart J 2013;34:1708\u201313, 13a\u201313b. https:\/\/doi.org\/10.1093\/eurheartj\/eht042; PMID: 23425521.","DOI":"10.1093\/eurheartj\/eht042"},{"key":"ref8","unstructured":"Bhatt DL, Cryer BL, Contant CF, et al. Clopidogrel with or without omeprazole in coronary artery disease. N Engl J Med 2010;363:1909\u201317. https:\/\/doi.org\/10.1056\/NEJMoa1007964; PMID: 20925534."},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Aradi D, Kirtane A, Bonello L, et al. Bleeding and stent thrombosis on P2Y12-inhibitors: collaborative analysis on the role of platelet reactivity for risk stratification after percutaneous coronary intervention. Eur Heart J 2015;36:1762\u201371. https:\/\/doi.org\/10.1093\/eurheartj\/ehv104; PMID: 25896078.","DOI":"10.1093\/eurheartj\/ehv104"},{"key":"ref10","unstructured":"Floyd CN, Ferro A. Mechanisms of aspirin resistance. Pharmacol Ther 2014;141:69\u201378. https:\/\/doi.org\/10.1016\/j.pharmthera.2013.08.005; PMID: 23993980."},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Floyd CN, Ferro A. Antiplatelet drug resistance: molecular insights and clinical implications. Prostaglandins Other Lipid Mediat 2015;120:21\u20137. https:\/\/doi.org\/10.1016\/j.prostaglandins.2015.03.011; PMID: 25868910.","DOI":"10.1016\/j.prostaglandins.2015.03.011"},{"key":"ref12","unstructured":"Collet JP, Cuisset T, Range G, et al. Bedside monitoring to adjust antiplatelet therapy for coronary stenting. N Engl J Med 2012;367:2100\u20139. https:\/\/doi.org\/10.1056\/NEJMoa1209979; PMID: 23121439."},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Trenk D, Stone GW, Gawaz M, et al. A randomized trial of prasugrel versus clopidogrel in patients with high platelet reactivity on clopidogrel after elective percutaneous coronary intervention with implantation of drug-eluting stents: results of the TRIGGER-PCI (Testing Platelet Reactivity In Patients Undergoing Elective Stent Placement on Clopidogrel to Guide Alternative Therapy With Prasugrel) study. J Am Coll Cardiol 2012;59:2159\u201364. https:\/\/doi.org\/10.1016\/j.jacc.2012.02.026; PMID: 22520250.","DOI":"10.1016\/j.jacc.2012.02.026"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Price MJ, Berger PB, Teirstein PS, et al. Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. JAMA 2011;305:1097\u2013105. https:\/\/doi.org\/10.1001\/jama.2011.290; PMID: 21406646.","DOI":"10.1001\/jama.2011.290"},{"key":"ref15","unstructured":"Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC\/EACTS guidelines on myocardial revascularization. Eur Heart J 2019;40:87\u2013165. https:\/\/doi.org\/10.1093\/eurheartj\/ehy394; PMID: 30165437."},{"key":"ref16","unstructured":"Angiolillo DJ, Rollini F, Storey RF, et al. International expert consensus on switching platelet P2Y12 receptor-inhibiting therapies. Circulation 2017;136:1955\u201375. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.117.031164; PMID: 29084738."},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Angiolillo DJ, Patti G, Chan KT, et al. De-escalation from ticagrelor to clopidogrel in acute coronary syndrome patients: a systematic review and meta-analysis. J Thromb Thrombolysis 2019;48:1\u201310. https:\/\/doi.org\/10.1007\/s11239-019-01860-7; PMID: 31004312.","DOI":"10.1007\/s11239-019-01860-7"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Bhatnagar P, Wickramasinghe K, Williams J, et al. The epidemiology of cardiovascular disease in the UK 2014. Heart 2015;101:1182\u20139. https:\/\/doi.org\/10.1136\/heartjnl-2015-307516; PMID: 26041770.","DOI":"10.1136\/heartjnl-2015-307516"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Floyd CN, Ferro A. Indications for anticoagulant and antiplatelet combined therapy. BMJ 2017;359:j3782. https:\/\/doi.org\/10.1136\/bmj.j3782; PMID: 28982662.","DOI":"10.1136\/bmj.j3782"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Lip GYH, Collet JP, Haude M, et al. Management of antithrombotic therapy in AF patients presenting with ACS and\/or undergoing PCI. Eur Heart J 2018;39:2847\u201350. https:\/\/doi.org\/10.1093\/eurheartj\/ehy396; PMID: 30137444.","DOI":"10.1093\/eurheartj\/ehy396"}],"container-title":["European Cardiology Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ecrjournal.com\/articleindex\/ecr.2019.09","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T15:53:57Z","timestamp":1613836437000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ecrjournal.com\/articleindex\/ecr.2019.09"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,26]]},"references-count":21,"URL":"https:\/\/doi.org\/10.15420\/ecr.2019.09","relation":{},"ISSN":["1758-3764","1758-3756"],"issn-type":[{"value":"1758-3764","type":"electronic"},{"value":"1758-3756","type":"print"}],"subject":[],"published":{"date-parts":[[2020,2,26]]},"article-number":"e08"}}