This editorial refers to ‘Smoking and outcomes following guided de-escalation of antiplatelet treatment in acute coronary syndrome patients: a substudy from the randomised TROPICAL-ACS trial’, by M. Orban et al., on page 372.
Dual antiplatelet therapy (DAPT) with aspirin plus P2Y12 inhibitors such as ticagrelor or prasugrel for one year remains the standard of care for most patients with acute coronary syndromes (ACS).1,2 Improved clinical outcomes with this strategy, in particular myocardial infarction, comes with increased risk of minor and major bleeding which can be associated with adverse clinical outcomes. Elevated platelet reactivity after ACS is associated with worse outcomes.
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