The Particulars: Dual antiplatelet therapy with aspirin and a P2Y12 platelet inhibitor has been beneficial in patients with unstable angina or non-STEMI. However, the optimal dual antiplatelet therapy strategy is unknown for many of these patients who do not undergo revascularization after angiography.

Data Breakdown: More than 7,000 patients with acute coronary syndromes (ACS) who were medically managed without revascularization and had at least one high-risk criterion participated in an international investigation. Patients who were triaged to receive aspirin and prasugrel, a P2Y12 platelet inhibitor, following angiography had lower rates of heart attack, stroke, and recurrent ischemic events. These patients also had a lower risk of meeting the combined endpoint of cardiovascular disease, hear attack, and stroke.

Take Home Pearl: Dual antiplatelet therapy with aspirin and prasugrel appears to reduce cardiovascular events among patients with ACS who are managed medically following angiography.