P2Y12 Inhibition vs. Aspirin for Secondary Coronary Prevention

A new meta-analysis suggests P2Y12 inhibition might provide greater benefit and less toxicity.

For patients with established coronary artery disease (CAD), current guidelines strongly recommend antiplatelet therapy with aspirin for prevention of vascular events. During the past several decades, P2Y12 inhibitors (e.g., clopidogrel, ticagrelor, and prasugrel) have also been shown to provide benefit in such patients, but the relative benefits and risks of these alternative antiplatelet agents compared with aspirin remain uncertain.

To address this gap in knowledge, investigators performed an individual patient–level meta-analysis of randomized trials comparing P2Y12 inhibitor monotherapy with aspirin monotherapy for secondary prevention in patients with established CAD. They identified 7 trials involving 24,325 patients (mean age, 64 yea…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)