A recent study by Cardiocentro Ticino Foundation found that P2Y12 inhibitor lowers the disease risk compared with aspirin alone in people with coronary artery disease without increasing bleeding risk.
Long-term therapy with aspirin is an important way of prevention in patients with blood vessel disease.
Life-long aspirin is the standard of care after an initial course of dual antiplatelet therapy (DAPT) with a P2Y12 inhibitor plus aspirin in patients with acute coronary syndrome.
Previous research found a significant, yet mild, reduction of heart events with clopidogrel therapy compared with aspirin therapy in patients with heart disease.
In the study, researchers examined the effect of therapy with currently recommended oral P2Y12 inhibitors (clopidogrel, prasugrel, or ticagrelor) versus aspirin in patients with established coronary artery disease.
The analysis included 24,325 patients, of which 12,178 were assigned to P2Y12 inhibitor therapy and 12,147 were assigned to aspirin therapy.
The treatment duration was 557 days. The average age of participants was 64.3 years and 21.7% were women.
The team found the risk of heart attacks and strokes was lower with P2Y12 inhibitor compared with aspirin.
In addition, P2Y12 inhibitor therapy was linked to a lower risk of heart attacks compared with aspirin therapy.
The team says the risk of heart attacks and strokes was reduced by 12% in patients receiving a P2Y12 inhibitor, primarily driven by a 23% relative reduction of a heart attack.
The overall risk of major bleeding did not differ, whereas gastrointestinal bleeding and hemorrhagic stroke occurred less frequently in patients receiving a P2Y12 inhibitor than aspirin monotherapy.
The study was conducted by Professor Marco Valgimigli et al and presented at ESC Congress 2022.
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