Antiplatelet therapy in elderly patients with acute coronary syndrome: Between scientific evidence and future perspectives

Submitted: April 24, 2018
Accepted: May 11, 2018
Published: June 7, 2018
Abstract Views: 3237
PDF: 634
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


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.



PlumX Metrics


Download data is not yet available.


How to Cite

Barillà, Francesco, Concetta Torromeo, Riccardo Iorio, Luigina Porco, Vincenzo Paravati, and Carlo Gaudio. 2018. “Antiplatelet Therapy in Elderly Patients With Acute Coronary Syndrome: Between Scientific Evidence and Future Perspectives”. Monaldi Archives for Chest Disease 88 (2).

Similar Articles

You may also start an advanced similarity search for this article.