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Heart Disease's Secret Weapon: Why Dual Antiplatelet Therapy Is So Important?
With changes in lifestyle and the increase in the elderly population, heart disease has become one of the major health threats worldwide. According to the World Health Organization, 9.7 million people die from heart disease every year. In order to prevent and treat heart diseases, the medical community is paying more and more attention to the application of antiplatelet therapy, especially dual antiplatelet therapy (DAPT). This therapy significantly reduces the risk of heart attack and stroke by reducing platelet aggregation and blood clot formation.
Antiplatelet drugs are effective in the arterial circulation and play an important role in the prevention and treatment of cardiovascular diseases.
What is dual antiplatelet therapy?
Dual antiplatelet therapy usually refers to combining aspirin with an ADP/P2Y inhibitor (such as clopidogrel, prasugrel, or ticagrelor) to achieve better therapeutic effects than either drug alone . This therapy is particularly suitable for patients with unstable angina, non-ST-segment elevation myocardial infarction, and other high-risk thrombotic diseases.
DAPT has been shown to significantly reduce heart attacks, strokes, and overall cardiovascular mortality, but is not recommended in low-risk patients because of a significantly increased risk of serious bleeding.
Classification of antiplatelet drugs
Antiplatelet drugs can be classified according to their mechanism of action:
- ADP receptor inhibitors: such as clopidogrel, prasugrel.
- Aspirin and its derivatives.
- Glycoprotein IIb/IIIa inhibitors: such as Abciximab and Eptifibatide.
Use of antiplatelet therapy
Antiplatelet therapy is indispensable in many medical conditions. Effective prevention and treatment of arterial blood clots is crucial in conditions such as heart surgery, coronary artery disease, and stroke. This class of drugs modulates platelet activation at the site of vascular injury, thereby preventing the formation of blood clots.
Effective antiplatelet therapy can reduce the catastrophic consequences of cardiovascular disease, such as heart attack or stroke.
Management during surgery
During surgery, continued antiplatelet therapy may increase the risk of bleeding, but discontinuation of antiplatelet therapy may increase the risk of thrombosis. Therefore, the risks and benefits of continuing versus discontinuing medication should be carefully evaluated in patients undergoing surgery. A 2018 systematic review found that for noncardiac surgery, the impact of continuing or discontinuing antiplatelet therapy on mortality and major bleeding events was modest.
Toxicity of antiplatelet drugs and dietary effects
The effectiveness of antiplatelet drugs may be affected by other drugs, medical conditions, and diet. Some foods and supplements, such as St. John's wort, garlic, and ginkgo, may increase the effects of antiplatelet medications, thereby increasing the risk of bleeding.
Properly assessing and managing a patient's bleeding risk is a very important step in dental care, especially when developing a treatment plan.
Summary
Dual antiplatelet therapy plays a key role in the management of heart disease, reducing the incidence of cardiovascular events. When faced with various injuries and risks, medical personnel need to balance the effectiveness of treatment with the risk of bleeding. In such a situation, every patient's situation is different, which reminds us that when implementing treatment plans, should we be more personalized to deal with different health challenges?
