The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)


Extending the aspirin-free paradigm to patients with acute coronary syndrome: is it time to change guidelines?

EuroIntervention 2020;16:620-622. DOI: 10.4244/EIJV16I8A115

1. University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; 2. Icahn School of Medicine at Mount Sinai, New York, NY, USA
Advances in medical therapeutics usually follow a typical pattern, with safety and efficacy initially established among high-risk patients prior to broader application in lower-risk individuals. In this regard, the withdrawal of aspirin (ASA) after percutaneous coronary intervention (PCI), or “aspirin-free” strategies, were first explored among patients with atrial fibrillation (AF) undergoing PCI in whom bleeding risk rendered the obligatory need for triple therapy prohibitive1. Numerous clinical trials have since shown that early withdrawal of ASA among such patients significantly lowers bleeding without compromising ischaemic risk as long as an oral anticoagulant and P2Y12 inhibition are maintained. Another ...

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