The conundrum of percutaneous coronary intervention without aspirin: a call for clarity

EuroIntervention 2023;19:13-14. DOI: 10.4244/EIJ-E-23-00017

Raffaele Piccolo
Raffaele Piccolo1, MD, PhD; Giovanni Esposito1, MD, PhD
1. Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
Aspirin is widely recognised as an essential component of antithrombotic therapy for secondary prevention, with societal guidelines recommending its use prior to percutaneous coronary intervention (PCI) and for lifelong maintenance therapy thereafter. The development of more potent P2Y12 receptor inhibitors, which provide a predictable antiplatelet effect, has led a shift in clinical research towards monotherapy with P2Y12 receptor inhibitors, without aspirin1. Aspirin discontinuation on a background of P2Y12 receptor inhibition has been tested at varying intervals, including 12 months, 3 to 6 months, and 1 month following PCI in experimental arms of randomised trials. This approach presents a&...

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