@article{Barillà_Torromeo_Iorio_Porco_Paravati_Gaudio_2018, title={Antiplatelet therapy in elderly patients with acute coronary syndrome: Between scientific evidence and future perspectives}, volume={88}, url={https://www.monaldi-archives.org/macd/article/view/952}, DOI={10.4081/monaldi.2018.952}, abstractNote={<p>Dual antiplatelet therapy (DAPT) is an important strategy for reducing cardiovascular events (CV) after an acute coronary syndrome (ACS). Elderly patients undergoing DAPT have a higher risk of bleeding than younger patients for a variety of reasons. Stratification of thrombotic/hemorrhagic risk is mandatory in order to decide on the type and duration of DAPT. The percentage of patients ≥ 75 years represented in clinical trials is not large, so very often elderly people are prescribed treatment protocols only experimented on younger patients with a lower hemorrhagic risk. However, even in patients aged ≥ 75 treated with invasive or conservative therapy, after an ACS, a DAPT with aspirin 80-100 mg/day plus a P2Y12 receptor inhibitor for 12 months is recommended. In elderly patients, DAPT should be considered a dynamic process that can be modified over time based on the patient’s clinical conditions, or any other necessities (non-procrastinating surgical interventions, comorbid-like effects that can increase hemorrhagic risk). In patients with moderate-high or very high hemorrhagic risk, DAPT treatment should last less than 12 months. A prolongation of DAPT beyond 12 months in this setting is limited to a very low percentage of patients, after careful assessment of ischemic/hemorrhagic profile.</p>}, number={2}, journal={Monaldi Archives for Chest Disease}, author={Barillà, Francesco and Torromeo, Concetta and Iorio, Riccardo and Porco, Luigina and Paravati, Vincenzo and Gaudio, Carlo}, year={2018}, month={Jun.} }