48 y old male patient with anterior myocardial infarction has undergone a primary angioplasty with a bare metal stent . You are posted as a junior resident in the ward preparing a discharge card . What duration of antiplatelets will you advise to the patient ?
Stent thrombosis Prevention Acute (<24 h) Dual antiplatelet therapy (DAPT) Subacute(1-30 days) -Aspirin -P2Y12 receptor blocker(ticagrelor) Late (30 days-1 year) DAPT for up to 1 year - If DAPT is discontinued in the 1st month- 3 - 9 fold increased risk for stent thrombosis. - If elective surgery has to be done where discontinuation of antiplatelet therapy is required, surgery should be postponed for minimum 3 months and ideally for 6 months.
Acute coronary syndrome
Dual antiplatelets for 12months and then aspirin longterm
Ticagrelor for 1month and aspirin longterm
Aspirin for 1month and ticagrelor longterm
Ticagrelor alone is adequate longterm
Dual antiplatelets for 12months and then aspirin longterm