Use of Antiplatelet Agents in Canadian Patients: A Reflection of the 2023 Antiplatelet Guidelines

Antiplatelet agents play a fundamental role in secondary prevention of atherosclerotic cardiovascular disease by reducing the risk of recurrent ischemic events. Over the past decades, developments and refinements in antiplatelet therapy have been made through the commercialization of novel classes (P2Y12 inhibitors, glycoprotein [GP] IIb/IIIa inhibitors), modes of administration (oral and intravenous), and combination strategies (dual antiplatelet therapy [DAPT] of different durations). Recently, concerns have been raised regarding the prognostic impact of bleeding events associated with antiplatelet agents. Consequently, multiple strategies have been studied to optimize the fine balance between ischemic protection and bleeding avoidance with these agents. The 2023 Focused Update of the Guidelines for the Use of Antiplatelet Therapy by the Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology distilled the most recent evidence on this topic from a Canadian perspective. This review offers insights into the implementation of the guidelines’ recommendations in routine clinical practice within the Canadian setting.