Objective
to evaluate the optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent implantation according to bleeding risk (1 vs 3 months for high bleeding risk; 3 vs 12 months for non-high bleeding risk)
Study
open-label, multicentre, randomised clinical trial
Population
patients aged 19 years who received percutaneous coronary intervention with a drug-eluting stent (DES)
Endpoints
1) net adverse clinical events (NACE: composite of all-cause death, non-fatal MI, stent thrombosis, stroke, or BARC 3 or 5 bleeding); 2) major adverse cardiac or cerebral events (MACCE); 3) any actionable non-surgical bleeding (BARC 2, 3, or 5) at one year.
Conclusion
In HBR patients, 1-month DAPT did not achieve non-inferiority to 3-month DAPT for NACE; in non-HBR patients, 3-month DAPT was non-inferior to 12-month DAPT for NACE, MACCE and superior for reducing bleeding.
Kang et al. The Lancet. 2025 Nov 8.