Canadian Cardiovascular Society

Under the co-chair leadership of Drs. Kevin R. Bainey and Guillaume Marquis-Gravel, the Canadian Cardiovascular Society (CCS) and Canadian Association of Interventional Cardiology (CAIC) present the 2023 Focused Update of the Guidelines for the Use of Antiplatelet Therapy. Antiplatelet therapy (APT) is the foundation for the treatment and prevention of atherothrombotic events in people who have atherosclerotic cardiovascular disease.

The last update to this CCS/CAIC Guideline was in 2018. Since then, several randomized controlled trials on the use of antiplatelet agents in primary and secondary prevention of atherosclerotic cardiovascular disease have been published. With that new data considered, the following key messages and figures offer a range of evidence-based treatment pathways of care for your patients.

“We pride ourselves in creating the most up-to-date evidence-based guideline document for the use of antiplatelet therapy according to seven key clinical questions we felt were applicable to the clinician in clinical practice. These guidelines are simple and user-friendly for the busy clinician in everyday practice.” – Co-Chair, Dr Kevin R. Bainey.

View the key figures and messages below:

Potential use of acetylsalicylic acid (ASA) in primary prevention of cardiovascular disease.

Estimating bleeding risk for antiplatelet decision-making after percutaneous coronary intervention (PCI).

Estimating ischemic risk for antiplatelet decision-making after PCI.

Choice of dual APT (DAPT) in ACS patients who are medically treated without revascularization.

Use and duration of dual antiplatelet therapy in acute coronary syndromes and elective PCI with potent DAPT (P2Y12 inhibitor) choice in patients who present with an acute coronary syndrome (ACS), possible DAPT de-escalation strategies after PCI, and shortened DAPT in high bleeding risk patients.

Perioperative and longer-term antiplatelet management in patients who require coronary artery bypass grafting surgery.

Pretreatment consideration with DAPT (P2Y12 inhibitor) before elective or non-elective coronary angiography.

Use of APT in patients with atrial fibrillation who require oral anticoagulation after PCI or medically managed ACS.

For more information, read the updated Guideline here

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