Colegio Argentino de Cardioangiólogos Intervencionistas Revista Argentina de Cardioangiología intervencionista 2250-7531 2313-9307 14 2 2023 06 30 Antiplatelet therapy in acute coronary syndromes: what is the optimal therapy with the current generation of drug-eluting stents? 0067 0070 EN Luis A Guzmán Profesor de Medicina. Chippenham Hospital. Richmond, VA, USA loyguzman1705@gmail.com The managementof patients with acute coronary syndrome has progressedsignificantly over the past few decades primarily due to technological advancements made in interventional cardiology with the arrival of new drug-eluting stents, early reperfusion strategies, and a deeper understanding of anti-thrombotic therapy.The development and addition of more effective antiplatelet drugs to the therapeutic armamentarium along with the use of dual antiplatelet therapy with more potent P2Y12 receptor inhibitors (ticagrelor and prasugrel) have shown a significant reduction in the number of acute ischemic events following percutaneous revascularization. However, over time, careful assessmentof scientific studies and real-world practice registries has revealed that these more aggressive antiplatelet regimens are associated with a significant increase in bleeding complications that jeopardize the patient’s life. Different alternatives and treatment strategies were evaluated to determine the most suitable therapeutic approach that keeps a balance between preventing ischemic events (stent thrombosis, acute myocardial infarction or cardiovascular mortality) without increasing bleeding complications. This is how the concept of "de-escalation" and individualized antiplatelet treatment was born. antiplatelet drugs, prasugrel, ticagrelor, acute coronary syndroms, de-escalation http://www.raci.com.ar/contenido/art.php?recordID=MjQyNQ== http://recursos.meducatium.com.ar/contenido/articulos/31700670070_2425/pdf/31700670070.pdf