Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation

Abstract

Percutaneous coronary intervention is evolving rapidly. Among the developments in various aspects, dual antiplatelet therapy (DAPT) has played a pivotal role to reduce thrombotic events after stent implantation. After the introduction of the drug-eluting stent, prolonged DAPT has been recommended due to concerns regarding late and very late stent thrombosis. However, there are controversies regarding the benefit of long-term DAPT. In addition, prolonged DAPT accompanies increased bleeding risk as well as additional cost. To balance the benefit and risk, optimizing DAPT duration is crucial. In this article, clinical guidelines and studies regarding optimal duration of DAPT are discussed.

Keywords::

• drug-eluting stent
• dual antiplatelet therapy
• percutaneous coronary intervention
• thienopyridine

Financial & competing interest disclosure

The authors were supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A085012 and A102064), a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (no. A085136) and the Cardiovascular Research Center, Seoul, Republic of Korea. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.