Date of Award

Spring 5-2025

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Kauffman, Russ

Keywords

platelet aggregation inhibitors, P2Y12 inhibitor monotherapy, dual antiplatelet therapy, drug eluting stent

Abstract

According to the American Heart Association, there are approximately 1.4 million people who are hospitalized and 700,000 deaths attributed to acute coronary syndrome on a yearly basis in the United States. It is standard therapy for patients to receive a drug eluting stent and dual antiplatelet therapy to prevent occlusion of the stent and other coronary arteries. Dual antiplatelet therapy typically consists of aspirin and a P2Y12 inhibitor. Dual antiplatelet leads to an increased risk of bleeding. This literature review aims to investigate if earlier initiation of P2Y12 inhibitor monotherapy decreases the risk of bleeding while maintaining adequate protection against major adverse cardiac and cerebrovascular events. A literature review was performed using electronic search databases PubMed and Embase from May to July 2024. Keywords included platelet aggregation inhibitors, monotherapy, dual antiplatelet therapy, drug eluting stents, percutaneous coronary intervention, and three months. Studies published after 2018, randomized control trials, and clinical trials were considered. There were seven total studies that met these criteria. The current literature suggests that P2Y12 inhibitor monotherapy can be initiated after three months of dual antiplatelet therapy. Patients benefited by experiencing fewer bleeds and suffered from major adverse cardiac or cerebrovascular events at a similar rate compared to participants that continued dual antiplatelet therapy.

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