Duration of Dual Antiplatelet Therapy After Coronary Stenting: A Review of the Evidence.
The duration of dual antiplatelet therapy (DAPT) after coronary stenting has been evaluated in randomized studies with apparently conflicting results. Although longer exposure associates with more bleeding complications, late stent thrombosis (ST) and myocardial infarction are reduced. In addition, as new drug-eluting stents carry a lower risk of ST compared with the first-generation drug-eluting stents and possibly even bare-metal stents, a shift toward better protection from ST may have an effect on the duration and intensity of DAPT. Whether the duration of DAPT should be shorter or longer than the currently recommended 6 to 12 months is analyzed in this review, drawing on lessons from the most recent studies.
ACTION Study Group, Institut de Cardiologie (AP-HP), Centre Hospitalier Universitaire Pitié-Salpêtriėre, Paris, France. Electronic address: gilles.montalescot@psl.aphp.fr.
Gilles
G
Montalescot
Department of Cardiology, Concord Hospital, University of Sydney, Sydney, Australia.
David
D
Brieger
Milpark Hospital, Johannesburg, South Africa.
Anthony J
AJ
Dalby
Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Seung-Jung
SJ
Park
Icahn School of Medicine at Mount Sinai, Cardiovascular Research Foundation, New York, New York.
Roxana
R
Mehran
D023903:Coronary Restenosis / Q000175:diagnosis / Q000517:prevention & control; D054855:Drug-Eluting Stents / Q000639:trends*; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000639:trends; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic / Q000639:trends; D013997:Time Factors
D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists
P2Y(12) inhibitors; antiplatelet therapy; aspirin; coronary stent; drug-eluting stent