What is your preferred monotherapy antiplatelet agent to continue after completion of DAPT post-PCI for patients with stable ischemic heart disease?
Would coronary disease anatomy influence your selection of which type of antiplatelet agent to continue?
Answer from: at Community Practice
For stable CAD that is more extensive, I have been using Plavix monotherapy based on data from HOST-Exam although I have a discussion with the patient. ASA monotherapy is certainly OK if the patient prefers it. However, the downside to clopidogrel monotherapy is when a patient needs a procedure late...
As mentioned previously by multiple colleagues, the answer depends on the patient's CAD burden, history of ACS, risk factor control, etc.
I would prefer clopidogrel monotherapy in patients with more than one vessel PCI, patients with a prior history of ACS, ongoing smoking, history of CVA (ischem...
ASA or clopidogrel is a coin toss at this stage, with ASA ruffling fewer surgeon/dentist feathers than clopidogrel. Optimally, clopidogrel would offer similar anti-platelet activity to ASA, minus the GI cox-related bleeding risk.
I still use aspirin although I'm staying tuned as data seems to suggest that clopidogrel or perhaps ticagrelor may be preferable.
Again, I do have some concerns about interrupting antiplatelet agents for procedures as there is generally more comfort doing procedures on ASA as opposed to clopidogrel...
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at Langhorne Cardiology Consultants Inc Completely agree with Dr. @Collins. Most surgeons ...
My personal approach is that we in interventional cardiology are stent-centric and forget that evidence shows repeat events are not a consequence of stent thrombosis (1-2%) but by in large a consequence of plague rupture and thrombosis. Therefore, if one decides to use DAPT (understanding the increa...