SynthesisReviews in cardiovascular medicine2025
Antiplatelet Therapy in Chronic Coronary Artery Disease Patients With a History of Angioplasty. When is Aspirin Not Enough? A Systematic Review.
Synthesis in Reviews in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
Background: Antiplatelet therapy represents a cornerstone of secondary prevention in patients with chronic coronary syndrome (CCS) who have undergone percutaneous coronary intervention (PCI). However, the optimal antiplatelet regimen and optimal duration remain under investigation, as treatment must be individualized to balance the thrombotic and bleeding risks. Thus, this systematic review aimed to present the most recent evidence on antiplatelet strategies in chronic coronary syndrome patients with prior PCI, highlighting findings relevant to subgroups with increased thrombotic risk. Methods: A systematic search of the PubMed database, the Cochrane Library, and ClinicalTrials.gov was conducted up to 29 May 2025. Studies were screened and selected based on predefined eligibility criteria. A total of 14 studies were included and were synthesized narratively. Results: Extended dual antiplatelet therapy (DAPT) with ticagrelor plus aspirin, compared to aspirin alone, improved primary outcomes in 5101 patients with stable coronary disease and diabetes mellitus (hazard ratio (HR) 0.81; 95% confidence interval (CI), 0.71-0.93; Conclusion: Extended DAPT demonstrated benefits over 30 months, while clopidogrel monotherapy has shown sustained effectiveness for up to 5.8 years in CCS patients with a history of PCI. Individualized treatment based on thrombotic and bleeding risk remains essential. Large-scale randomized trials are warranted to define the populations most likely to benefit from long-term intensified antiplatelet therapy. The PROSPERO Registration: CRD420251069004, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251069004.
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