An AHA scientific statement reviews contemporary evidence on antiplatelet therapy in acute and chronic coronary syndromes. Its starting point is that choice of agent, intensity and duration are now tailored to the patient, the procedure and the disease, rather than following one fixed course.
That tailoring brings risk. The statement highlights how frequent handovers between interventional teams, general cardiology, primary care and pharmacy, along with cost and access barriers, lead to inappropriate prescribing and non-adherence. It argues for shared responsibility across cardiologists, pharmacists and advanced practice nurses.
This is a scientific statement, not a guideline, and it does not change recommendations on any specific regimen. Its value is in naming where the failures happen: at discharge, at the first outpatient visit, and when the planned duration of dual therapy ends.
- At discharge after ACS or PCI, record the planned agent, duration and the date dual therapy should step down.
- At the first outpatient visit, confirm the patient is taking the P2Y12 inhibitor and can afford it.
- Involve a pharmacist when a patient on dual antiplatelet therapy also needs an anticoagulant.
- Recheck bleeding risk when circumstances change, such as new anaemia or planned surgery.
Why it matters
Most antiplatelet errors happen between teams, not within one.
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