Role of Monotherapy with a P2Y12 Inhibitor for Secondary Prevention in Patients with Established Atherosclerosis.

PURPOSE OF REVIEW: The role of monotherapy with a P2Y12 inhibitor for secondary prevention of cardiovascular diseases has been assessed in several randomized trials. In this article, we summarize the evidence regarding P2Y12 monotherapy for secondary prevention in each one of the major vascular territories.

RECENT FINDINGS: Available data including a large recent meta-analysis show no differences in terms of all-cause death, vascular death, stroke, and a minor difference of the risk of myocardial infarction with P2Y12 monotherapy as compared to dual antiplatelet therapy. Overall, mono antiplatelet therapy with aspirin and the P2Y12 inhibitors appear similar in efficacy. However, there are clinical conditions that may suggest one drug regimen over another in secondary prevention. The risk of bleeding must always be weighed in each patient individually for the optimal choice of the antiplatelet regimen.