REVIEW  PCI HOT TOPICS 

Minerva Cardioangiologica 2020 October;68(5):436-50

DOI: 10.23736/S0026-4725.20.05196-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Dual antiplatelet therapy duration after percutaneous coronary intervention with drug-eluting stents: how short can we go?

Fausto ROCCASALVA ^{1, 2}, Giuseppe FERRANTE ^{1, 2} ✉

¹ Department of Cardiovascular Medicine, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy; ² Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

Current guidelines recommend a duration of dual antiplatelet therapy (DAPT) with aspirin and oral P2Y12 receptor inhibitors following percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) of 6 months for most patients with stable coronary disease and of 12 months for most patients with acute coronary syndromes. Large evidence from randomised clinical trials of shorter DAPT regimens after PCI with newer-generation DES is now emerging in heterogenous patient population not selected on the basis of high bleeding risk as well as in patients at high bleeding risk. The scope of this review is to provide an update on the benefits and harms of these short DAPT regimens and to discuss future directions in DAPT strategies after PCI with newer generation DES.

KEY WORDS: Dual anti-platelet therapy; Drug-eluting stents; Hemorrhage