Retiro de la aspirina antes de los 30 días post-angioplastia en el síndrome coronario agudo
Una revisión sistemática y metanálisis publicada este 24 de septiembre evaluó la desescalada precoz hacia monoterapia con inhibidores potentes de P2Y12 (ticagrelor o prasugrel), suspendiendo el ácido acetilsalicílico antes del primer mes tras una angioplastia coronaria (PCI):
- Balance isquemia vs. hemorragia: La interrupción ultratemprana de la aspirina reduce sustancialmente los episodios de sangrado digestivo y mayor, sin mostrar un aumento estadísticamente significativo en trombosis aguda del stent o reinfarto precoz en poblaciones seleccionadas tratadas con stents liberadores de fármaco de última generación.
- Implicancia asistencial: Aporta evidencia para personalizar la duración de la doble antiagregación plaquetaria (DAPT), desafiando el dogma tradicional que exigía un mínimo inamovible de 3 a 12 meses de tratamiento dual en todos los pacientes post-SCA
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