Shorter Dual Antiplatelet Therapy May Be an Option for Patients Undergoing PCI

By the Editors

Two JAMA studies suggest that a shorter duration of dual antiplatelet therapy (DAPT) may be acceptable after percutaneous coronary intervention (PCI) with a drug-eluting stent.

In the first trial, some 3000 patients undergoing PCI were randomized to either 1 month of DAPT followed by clopidogrel alone or 12 months' DAPT. At 12 months, shorter DAPT was superior to longer treatment for the primary composite outcome of cardiovascular death, myocardial infarction, stroke, definite stent thrombosis, or bleeding (2.4% vs. 3.7%).

In the second trial, 3000 patients undergoing PCI were randomized either to 3 months of DAPT followed by P2Y12 monotherapy (most often, clopidogrel) or to 12 months' DAPT. Shorter DAPT was noninferior to longer treatment for major adverse cardiac and cerebrovascular events.

Dr. Howard Hermann says the findings may warrant a change to current guidelines. See his perspective in NEJM Journal Watch Cardiology at the first link below.