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Carciotto et al. Vessel Plus 2024;8:33                                     Vessel Plus
               DOI: 10.20517/2574-1209.2024.01



               Review                                                                        Open Access



               De-escalating antiplatelet therapy in patients with

               acute coronary syndrome


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                               1,2
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               Gabriele Carciotto , Mattia Galli , Victoria Garcia-Ruiz , Emmanuele Soraci , Alberto Magliarditi , Paolo
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                    2
                                                                 6
                                1,2
                                                1,2
                                                                                  1
               Liotta , Lucio Teresi , Marco Franzino , Simone Zecchino , Deborah Bonfiglio , Italo Porto , Rocco
                                                            10
                      7,8
                                                                                             12
                                               9
               Vergallo , Antonio Giovanni Versace , Fabrizio Oliva , Claudio Montalto 10,11 , Giorgio Quadri , Giampiero
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                     1,2
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               Vizzari , Fausto Castriota , Piera Capranzano , Ferdinando Varbella , Giuseppe Musumeci , Antonio
                    1,2
               Micari , Francesco Costa 2-14
               1
                Division of Cardiology, University Hospital Policlinico G Martino, Messina 98124, Italy.
               2
                Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Messina
               98122, Italy.
               3
                Maria Cecilia Hospital, GVM Care & Research, Cotignola 48033, Italy.
               4
                Division of Cardiology, GIOMI Hospital, Messina 98165, Italy.
               5
                Dipartimento Funzionale di Medicina, U.O.S. Emodinamica, Ospedale Barone Romeo di Patti, Messina 98066, Italy.
               6
                Interventional Cardiology Unit, Degli Infermi Hospital, Turin 10098, Italy.
               7
                Cardiothoracic and Vascular Department, IRCCS Ospedale Policlinico San Martino, Genova 16132, Italy.
               8
                Department of Internal Medicine and Medical Specialties, Università di Genova, Genova 16132, Italy.
               9
                Emergency Medicine Unit, Papardo Hospital, Messina 98166, Italy.
               10
                Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan 20162, Italy.
               11
                Department of Medicine and Surgery, University of Milano Bicocca, Milan 20126, Italy.
               12
                S.C.Cardiologia, AO Ordine Mauriziano, Torino 10128, Italy.
               13
                Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, University of Catania, Catania 95123, Italy.
               14
                Área del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, IBIMA Plataforma BIONAND, Departamento de
               Medicina UMA, Malaga, Spain, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV).
               Correspondence to: Prof. Antonio Micari, Department of Biomedical and Dental Sciences and of Morphological and Functional
               Images, University of Messina, Piazza Pugliatti 1, Messina 98122, Italy. E-mail: micariantonio@gmail.com
               How to cite this article: Carciotto G, Galli M, Garcia-Ruiz V, Soraci E, Magliarditi A, Liotta P, Teresi L, Franzino M, Zecchino S,
               Bonfiglio D, Porto I, Vergallo R, Versace AG, Oliva F, Montalto C, Quadri G, Vizzari G, Castriota F, Capranzano P, Varbella F,
               Musumeci G, Micari A, Costa F. De-escalating antiplatelet therapy in patients with acute coronary syndrome. Vessel Plus
               2024;8:33. https://dx.doi.org/10.20517/2574-1209.2024.01
               Received: 27 Jan 2024  First Decision: 22 May 2024  Revised: 20 Jul 2024  Accepted: 13 Sep 2024  Published: 27 Sep 2024
               Academic Editors: Frank W. Sellke, Annie Laurie W. Shroyer  Copy Editor: Yu-Fei Wang  Production Editor: Yu-Fei Wang
               Abstract
               Dual antiplatelet therapy (DAPT), combining aspirin and a P2Y12 receptor inhibitor, is the basis of acute coronary
               syndrome (ACS) treatment, demonstrating efficacy in reducing ischemic complications while being linked to
               increased bleeding. Recent interest has emerged in bleeding reduction strategies, specifically de-escalation
               strategies involving P2Y12 inhibitor potency and dosage modulation that can be achieved in two different ways: the
                           © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
                           International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
                           adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
               long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
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