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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
7,8
2
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1,2
1,2
1
Liotta , Lucio Teresi , Marco Franzino , Simone Zecchino , Deborah Bonfiglio , Italo Porto , Rocco
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7,8
12
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Vergallo , Antonio Giovanni Versace , Fabrizio Oliva , Claudio Montalto 10,11 , Giorgio Quadri , Giampiero
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Vizzari , Fausto Castriota , Piera Capranzano , Ferdinando Varbella , Giuseppe Musumeci , Antonio
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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.
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Maria Cecilia Hospital, GVM Care & Research, Cotignola 48033, Italy.
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Division of Cardiology, GIOMI Hospital, Messina 98165, Italy.
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Dipartimento Funzionale di Medicina, U.O.S. Emodinamica, Ospedale Barone Romeo di Patti, Messina 98066, Italy.
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Interventional Cardiology Unit, Degli Infermi Hospital, Turin 10098, Italy.
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Cardiothoracic and Vascular Department, IRCCS Ospedale Policlinico San Martino, Genova 16132, Italy.
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Department of Internal Medicine and Medical Specialties, Università di Genova, Genova 16132, Italy.
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Emergency Medicine Unit, Papardo Hospital, Messina 98166, Italy.
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Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan 20162, Italy.
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Department of Medicine and Surgery, University of Milano Bicocca, Milan 20126, Italy.
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S.C.Cardiologia, AO Ordine Mauriziano, Torino 10128, Italy.
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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
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