ESC TV Today – Your Cardiovascular News Season 3 - Ep.8: Extended interview on dual antiplatelet therapy in 2025
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Jan 30, 2025 Gilles Montalescot, a Professor of Cardiology at Pitié University Hospital, dives into the evolving landscape of antiplatelet therapy for coronary syndromes. He discusses the importance of adapting treatment recommendations based on new research and patient diversity. The conversation highlights the complexities of managing dual therapy in high-risk patients and the critical balance between reducing ischemic risks and preventing bleeding. Montalescot also emphasizes the need for innovative strategies for timely interventions in STEMI patients.
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Dynamic Guidelines
- Guidelines for antiplatelet therapy are constantly evolving due to new research.
- What was considered best practice 20 years ago may not be valid today, highlighting the dynamic nature of medical knowledge.
Chronic Coronary Syndrome Management
- In chronic coronary syndromes, patients should receive lifelong single antiplatelet therapy, usually aspirin.
- Following stenting, add a P2Y12 inhibitor like clopidogrel for 1–3 months, then revert to aspirin.
Acute Coronary Syndrome Management
- Treat acute coronary syndromes with dual antiplatelet therapy (aspirin plus a P2Y12 inhibitor like ticagrelor or prasugrel) for one year.
- New studies suggest shortening this duration, potentially to 1–3 months, favoring P2Y12 inhibitors for long-term prevention.