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Circulation · 2026

Multidisciplinary Approach to Antiplatelet Management in Coronary Syndromes: A Scientific Statement From the American Heart Association.

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Beavers Craig J, Dobesh Paul P, Cushman Mary, DiDomenico Robert J, Ijioma Nkechinyere, Joshi Ravi V, Medina-Beckwith Jonathan, Pereira Naveen, Ruel Marc, Tabak Rachel G, American Heart Association Clinical Pharmacology Committee of the Council of Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Genomic and Precision Medicine

Аннотация

Antiplatelet therapy is a cornerstone of care for patients with acute coronary syndrome and chronic coronary disease, yet its optimal use requires careful balancing of thrombotic risk reduction with bleeding complications. Since the mid-2000s, advances in stent technology, antiplatelet pharmacotherapy, procedural technique, and risk stratification tools have led to increasingly individualized approaches to antiplatelet management. Current guidelines and evidence emphasize tailoring agent selection, intensity, and duration of therapy according to patient-, procedure-, and disease-specific factors rather than a uniform strategy. However, the growing complexity of evidence, frequent care transitions, social determinants of health, and variability in patient characteristics have increased the risk of inappropriate prescribing, nonadherence, and adverse outcomes. This scientific statement reviews contemporary evidence informing antiplatelet strategies and highlights the critical role of the multidisciplinary cardiovascular team (interventional cardiology, general cardiology, pharmacists, advanced practice nurses) and the importance of their collective expertise in ensuring antithrombotic stewardship in patients with acute coronary syndrome and chronic coronary disease.