Platelet P2Y12 Inhibitor Monotherapy after Percutaneous Coronary Intervention: An Emerging Option for Antiplatelet Therapy De-escalation

Antiplatelet therapy is considered essential for secondary prevention of ischemic heartdisease. After percutaneous coronary intervention (PCI), temporary dual antiplatelettherapy (DAPT), a combination consisting of aspirin andan oral P2Y12 receptor blocker,is recommended. In the long term, this strategy results in more bleeding thanantiplatelet therapy with aspirin alone. Therefore, to reduce bleeding, an increasingtrend has been to keep DAPT as short as clinically acceptable, after which aspirinmonotherapy is continued. Another option to diminish bleeding is to discontinueaspirin at the moment of DAPT cessation after PCI, and to continue on P2Y12 blockermonotherapy. This survey reviews the evidence on P2Y12 blocker monotherapy. Someclinical guidance will be provided on when and in whom P2Y12 inhibitor monotherapymay be applied after DAPT cessation following PCI