Dual antiplatelet therapy may prevent coronary ischemic events beyond one year—the case for extended treatment

Abstract Platelet inhibition is one of the cornerstones of treatment for coronary artery disease. Aspirin and a P2Y12 receptor antagonists such as clopidogrel, prasugrel, or ticagrelor potently inhibit platelets and create the combination commonly referred to as dual antiplatelet therapy (DAPT). Essential in the acute setting after percutaneous coronary intervention and in the months that follow, but controversial when used years after intervention, DAPT—and the optimal duration for use—has been the subject of many studies. In this chapter, we review the evidence and make the case for extended treatment for patients who are particularly vulnerable to recurrent ischemic events.