Cardiovascular Research Technologies 2025: Beyond the Guidelines: DAPT selection and duration before and after PCI.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine Pub Date : 2025-06-30 DOI:10.1016/j.carrev.2025.06.035

Kalyan R Chitturi, Gregg W Stone, Roxana Mehran, Pieter C Smits, Douglas E Drachman, Dominick J Angiolillo, Grant W Reed, Usman Baber, C Michael Gibson, Ron Waksman

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引用次数: 0

Abstract

Dual antiplatelet therapy (DAPT) remains a cornerstone of secondary prevention in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS). The balance between ischemic protection and bleeding risk has driven refinements in therapy duration. In 2025, the American College of Cardiology (ACC), American Heart Association (AHA), American College of Emergency Physicians (ACEP), National Association of EMS Physicians (NAEMSP), and the Society of Cardiovascular Angiography and Interventions (SCAI) released joint guidelines on the management of patients with ACS, with a particular emphasis on DAPT duration. Considering these recently updated guidelines, the 2025 Cardiovascular Research Technologies (CRT) conference convened a session with leading interventional cardiology experts, entitled "Beyond the Guidelines - DAPT Selection and Duration Before and After PCI" to discuss implementation strategies for DAPT based on unique clinical scenarios and the new guideline recommendations. This article synthesizes the current guideline-directed recommendations and expert discussion to provide an evidence-based perspective on beyond the guidelines topics such as optimal DAPT duration, individualized de-escalation strategies, and evolving treatment paradigms for special populations.

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心血管研究技术2025：超越指南：DAPT选择和PCI前后持续时间。

双重抗血小板治疗（DAPT）仍然是急性冠脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）的二级预防的基石。缺血保护和出血风险之间的平衡推动了治疗持续时间的改进。2025年，美国心脏病学会（ACC）、美国心脏协会（AHA）、美国急诊医师学会（ACEP）、全国急诊医师协会（NAEMSP）和心血管血管造影与干预学会（SCAI）发布了ACS患者管理联合指南，特别强调了DAPT持续时间。考虑到这些最近更新的指南，2025年心血管研究技术（CRT）会议召集了一场由领先的介入心脏病学专家参加的会议，题为“超越指南- DAPT选择和PCI前后持续时间”，讨论基于独特临床情况和新指南建议的DAPT实施策略。本文综合了目前的指南指导建议和专家讨论，提供了一个基于证据的视角，超越指南的主题，如最佳DAPT持续时间，个性化的降级策略，以及特殊人群的不断发展的治疗范例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.30

自引率

5.90%

发文量

687

审稿时长

36 days

期刊介绍： Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.