Improving Outcomes for Patients Undergoing Percutaneous Coronary Intervention

Guidelines for patients after percutaneous coronary intervention (PCI) include treatment with dual antiplatelet therapy (DAPT) with aspirin and a P2Y₁₂ inhibitor to reduce recurrent atherothrombotic events, including stent thrombosis. Prolonged DAPT reduces the risks for ischemic outcomes but can also elevate bleeding risks, which limits its attractiveness, particularly with more-potent P2Y₁₂ inhibitors. In several recent studies, shortening the duration of DAPT (by reducing the duration of either aspirin or the P2Y₁₂ antagonist) seemed to reduce bleeding complications, but this approach was not tested specifically in patients with acute coronary syndromes (ACS). Moreover, these studies were underpowered to examine ischemic outcomes. Two re…