Study suggests extending post-stenting DAPT beyond one year

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Extending clot-preventing dual antiplatelet therapy (DAPT) beyond the recommended 12 months after coronary stenting “should be considered” in patients at low risk for bleeding, investigators for the OPTIDUAL trial recommend. Results of the trial were presented at ESC, held in August-September in London.

While the investigator-initiated study showed that DAPT (a combination of aspirin and the P2Y12-receptor blocker clopidogrel) does not decrease the rate of major adverse cardiovascular and cerebrovascular events (MACCE), there was nevertheless a hint that it might reduce ischemic outcomes without excess bleeding.

“Given the lack of harm and the signal for benefit of prolonged DAPT in the OPTIDUAL trial, and the results from prior randomised trials testing long durations of DAPT, prolongation of DAPT beyond 12 months should be considered in patients without high-risk bleeding, who have received a drug-eluting coronary stent and are event-free ...