An American Heart Association scientific statement reviews current evidence on antiplatelet therapy in acute coronary syndrome and chronic coronary disease. Its central argument is that the choice of agent, intensity and duration now varies so much by patient, procedure and disease that a single prescriber at a single moment cannot manage it safely.
The statement points to care transitions, social circumstances and the sheer complexity of regimens as the main sources of inappropriate prescribing and non-adherence. It describes a stewardship model in which interventional cardiologists, general cardiologists, pharmacists and advanced practice nurses share responsibility for the plan.
This is a review statement, not a new guideline, and it does not change recommended durations. Its practical value is in the handovers: discharge, the first clinic visit and the moment someone outside cardiology wants to stop a drug for a procedure.
- Write the intended agent, dose and planned stop or de-escalation date on the discharge summary
- Check at the first follow-up that the patient is actually taking both antiplatelet drugs
- Ask about cost and supply; missed P2Y12 doses after discharge are often financial
- Give the patient a clear instruction not to stop therapy for a dental or surgical procedure without speaking to the cardiology team
- Involve a pharmacist when an anticoagulant is added to antiplatelet therapy
Why it matters
Most antiplatelet errors happen at handovers, which is where this statement asks teams to look.
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