Evidence map›Paper›PMID 36362474›Full record

ReviewJournal of clinical medicine2022

Escalation and De-Escalation of Antiplatelet Therapy after Acute Coronary Syndrome or PCI: Available Evidence and Implications for Practice.

Felice Gragnano, Antonio Capolongo, Fabrizia Terracciano, Giuseppe Gargiulo, Vincenzo De Sio, Arturo Cesaro, Elisabetta Moscarella, Giuseppe Patti, Italo Porto, Giovanni Esposito and 2 more

Abstract readReview
In one paragraph

Review in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Antiplatelet Therapy in Heart Disease.Reviews in cardiovascular medicine · 2025
    Review
  4. Review
  5. Clopidogrel resistance and its relevance: Current concepts.Journal of family medicine and primary care · 2024
    Review
  6. Article
  7. Impact ofPharmacogenomics
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Felice GragnanoDepartment of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.ORCID 0000-0002-6943-278X
Antonio CapolongoDepartment of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
Fabrizia TerraccianoDepartment of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
Giuseppe GargiuloDepartment of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy.
Vincenzo De SioDepartment of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
Arturo CesaroDepartment of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.ORCID 0000-0003-4435-1235
Elisabetta MoscarellaDepartment of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.ORCID 0000-0002-7494-4640
Giuseppe PattiDepartment of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy.ORCID 0000-0002-5404-3968
Italo PortoDivision of Cardiovascular Medicine, Policlinico San Martino, University of Genova, 16132 Genova, Italy.ORCID 0000-0002-9854-5046
Giovanni EspositoDepartment of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy.
Dominick J AngiolilloDivision of Cardiology, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
Paolo CalabròDepartment of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.ORCID 0000-0002-5018-830X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Dual antiplatelet therapy (DAPT) is the gold standard for the antithrombotic management of patients with an acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI). Implementation of intensified or prolonged DAPT regimens has proven to lower the risk of ischemic events but at the expense of increased bleeding. Importantly, bleeding is a predictor of poor prognosis. Risk stratification and selection of tailored antiplatelet strategies to maximize the net clinical benefit in individual patients with ACS or undergoing PCI is therefore potentially beneficial. Recently, novel approaches including DAPT de-escalation or escalation have been proposed as possible alternatives to standard DAPT. These strategies, which are generally based on patient's risk profile, genetics, and/or platelet function have been proposed to offer more tailored treatments in patients with ACS or PCI, with the ultimate goal of providing adequate ischemic protection while mitigating the risk of bleeding. This review summarizes the available evidence on DAPT de-escalation or escalation (both guided and unguided) and discusses the practical implications of these strategies in the contemporary management of patients with ACS and/or undergoing PCI.

Indexed as

aspirinDAPTde-escalationescalationguided-therapyP2Y12 inhibitors

Identifiers

PMID36362474
PMCPMC9654330

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.