Circulation. 2026 Oct 13. doi: 10.1161/CIR.0000000000001478. Online ahead of print.
ABSTRACT
Antiplatelet therapy is a cornerstone of care for patients with acute coronary syndrome and chronic coronary disease, yet its optimal use requires careful balancing of thrombotic risk reduction with bleeding complications. Since the mid-2000s, advances in stent technology, antiplatelet pharmacotherapy, procedural technique, and risk stratification tools have led to increasingly individualized approaches to antiplatelet management. Current guidelines and evidence emphasize tailoring agent selection, intensity, and duration of therapy according to patient-, procedure-, and disease-specific factors rather than a uniform strategy. However, the growing complexity of evidence, frequent care transitions, social determinants of health, and variability in patient characteristics have increased the risk of inappropriate prescribing, nonadherence, and adverse outcomes. This scientific statement reviews contemporary evidence informing antiplatelet strategies and highlights the critical role of the multidisciplinary cardiovascular team (interventional cardiology, general cardiology, pharmacists, advanced practice nurses) and the importance of their collective expertise in ensuring antithrombotic stewardship in patients with acute coronary syndrome and chronic coronary disease.
PMID:42866888 | DOI:10.1161/CIR.0000000000001478