Personalized Antithrombotic Therapy After Percutaneous Coronary Intervention: A Systematic Review of Risk-Stratified Approaches.
Catheter Cardiovasc IntervJul 6, 2026 (epub)
Thierry Kochkarian, Anis Ismail, Omar Chaabo et al.
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In 30 seconds
This systematic review analyzed 80 studies involving over 330,000 patients to compare personalized antithrombotic therapy versus fixed dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). The findings indicate that personalized strategies can reduce major bleeding by up to 65%, while ischemic risk varies across populations and strategies, with some showing increased myocardial infarction risk when aspirin is withdrawn early.
Key findings
- Personalized strategies can reduce major bleeding by up to 65%.
- In high-bleeding-risk patients, 1 to 3-month DAPT followed by P2Y12 monotherapy lowers major bleeding without increasing myocardial infarction.
- Prasugrel is favored over ticagrelor for better ischemic outcomes in acute coronary syndrome.
Why it matters
The shift from fixed DAPT to risk-stratified approaches allows for tailored antithrombotic therapy, potentially improving patient outcomes by minimizing bleeding risks while managing ischemic events effectively.