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.
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
Acute coronary syndrome