Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease

Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease is a comprehensive reference that provides updated information on the advantages and disadvantages of dual antiplatelet therapy, its duration, composition, and anticipated changes. It discusses the basis for DAPT in arterial disease and presents data on shorter than usual duration and extended therapy beyond current guidelines. It also includes a clinically relevant and updated compendium of data and anticipated trends and innovations in the next 3-5 years.

Format: Paperback / softback
Length: 220 pages
Publication date: 12 January 2021
Publisher: Elsevier Science Publishing Co Inc

Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease is a comprehensive reference that provides up-to-date information on the benefits and drawbacks of dual antiplatelet therapy, its duration, composition, and expected changes. The foundation of DAPT in arterial disease is discussed, allowing readers to understand platelet physiology and its relevance to ischemic events. Data on shorter than usual duration of DAPT and extended therapy beyond the recommendation of current guidelines is presented in great detail, summarizing a large body of evidence into concrete, relevant recommendations that are readily adaptable by practicing clinicians. A clinically relevant and updated compendium of data pertaining to this field is also presented, as well as the anticipated trends and innovations likely to occur in the next 3-5 years.

Dual Antiplatelet Therapy (DAPT) is a widely used treatment strategy for patients with coronary and peripheral arterial disease. It involves the simultaneous administration of two antiplatelet drugs, typically aspirin and clopidogrel, to reduce the risk of cardiovascular events such as heart attacks and strokes. The use of DAPT has been extensively studied and has shown significant benefits in reducing the incidence of cardiovascular events in patients with established cardiovascular disease.

One of the key advantages of DAPT is its ability to prevent platelet aggregation and adhesion, which are critical steps in the development of arterial thrombosis. Platelets are blood cells that play a crucial role in the clotting process, but when they become activated or adhere to the walls of blood vessels, they can cause blood clots to form, which can lead to heart attacks and strokes. By inhibiting the activity of platelets, DAPT reduces the risk of these life-threatening events.

Another advantage of DAPT is its ability to reduce the risk of recurrent cardiovascular events in patients who have already experienced a heart attack or stroke. Studies have shown that DAPT can reduce the risk of repeat cardiovascular events by up to 50% compared to monotherapy with either aspirin or clopidogrel. This reduction in risk is attributed to the combined effects of the two antiplatelet drugs, which work synergistically to prevent platelet activation and adhesion.

However, DAPT is not without its risks and side effects. One of the most common side effects of DAPT is bleeding, which can occur in the stomach, intestines, or brain. Bleeding can be severe and may require hospitalization or even blood transfusions. Other side effects of DAPT include headache, fatigue, and nausea.

In addition to its benefits, DAPT has also been associated with certain risks. For example, patients who are at high risk of bleeding, such as those with a history of gastrointestinal bleeding or liver disease, may be at increased risk of bleeding complications with DAPT. Additionally, DAPT may increase the risk of heart failure in patients with underlying heart disease, particularly if they are also taking certain medications such as diuretics or beta-blockers.

The duration of DAPT varies depending on the individual patient and their risk factors for cardiovascular disease. In general, patients with coronary artery disease are typically prescribed DAPT for at least one year after a heart attack or stent placement. Patients with peripheral arterial disease may be prescribed DAPT for a longer duration, depending on the severity of their disease and their risk factors.

The composition of DAPT also varies depending on the individual patient and their risk factors. In general, patients with coronary artery disease are prescribed aspirin at a dose of 75-100 mg daily, while clopidogrel is typically prescribed at a dose of 75 mg daily. Patients with peripheral arterial disease may be prescribed higher doses of aspirin or clopidogrel, depending on their disease severity and risk factors.

There are ongoing discussions and research in the field of DAPT regarding its duration, composition, and potential changes. One area of interest is the potential for shorter duration of DAPT, particularly in patients with low bleeding risk. Studies have shown that shorter duration of DAPT may be as effective as longer duration in reducing the risk of cardiovascular events, while also reducing the risk of bleeding complications.

Another area of interest is the use of alternative antiplatelet drugs in DAPT. Some studies have shown that newer antiplatelet drugs, such as prasugrel or ticagrelor, may be more effective than aspirin and clopidogrel in reducing the risk of cardiovascular events. However, these newer drugs also have their own risks and side effects, and their use should be carefully considered in the context of individual patient characteristics and risk factors.

In conclusion, dual antiplatelet therapy is a widely used treatment strategy for patients with coronary and peripheral arterial disease. It has significant benefits in reducing the risk of cardiovascular events and recurrent events in patients who have already experienced a heart attack or stroke. However, DAPT is not without its risks and side effects, and the duration, composition, and potential changes in DAPT treatment are ongoing areas of research and discussion. Patients and healthcare providers should work together to carefully consider the benefits and risks of DAPT and to choose the most appropriate treatment strategy for each individual patient.

Weight: 466g
Dimension: 191 x 235 x 18 (mm)
ISBN-13: 9780128205365