Is 1 Year of Dual Antiplatelet Therapy After Stenting Really Necessary?

Two randomized studies challenge the need for prolonged DAPT.

After percutaneous coronary intervention (PCI) with a drug-eluting stent (DES), current guidelines recommend dual antiplatelet therapy (DAPT) with aspirin and a thienopyridine lasting ≥6 months in patients with stable coronary artery disease (CAD) or ≥12 months in patients with acute coronary syndrome (ACS). Two research groups have now examined this recommendation.

In the randomized, stent-manufacturer–funded, Japanese STOPDAPT-2 trial (NCT02619760), Watanabe and colleagues compared 1 month of DAPT followed by clopidogrel monotherapy versus 12 months of DAPT in 3009 patients undergoing PCI (stable CAD, 62%). The first month in both groups could be prasugrel (38% of patients) or clopidogrel. Not all short-DAPT patients stopped aspirin at 1 m…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)