Cardiology>>>>>Ischaemic heart disease
Question 25#

You are completing the discharge summary for a patient who has undergone primary angioplasty with a bare metal stent for an anterior myocardial infarction. The pharmacist questions you regarding the duration of antiplatelets.

What do you advise? 

A) Dual antiplatelets for 12 months and then aspirin long term
B) Ticagrelor for 1 month and aspirin long term
C) Aspirin for 1 month and ticagrelor long term
D) Ticagrelor alone is adequate long term
E) Dual antiplatelets long term

Correct Answer is A


Current guidelines in the UK and Europe are 12 months dual-antiplatelet therapy (DAPT) after an acute coronary syndrome irrespective of the treatment or stent type. In elective angioplasty with a bare metal stent only 1 month of DAPT is required, followed by long-term aspirin as opposed to 12 months for drug-eluting stents (DESs). However, new-generation DESs with biocompatible or biodegradable polymers (the delivery agent for the drug) are showing safety with shorter durations, down to 3 months in some cases.