Key result
OCT-guided DAPT under 3 months post-DES may reduce bleeding without increasing stent thrombosis.
Why the study?
Shortening DAPT duration would benefit patients with high bleeding risk, but whether early healing patterns assessed by OCT support safe shortening after DES implantation requires evaluation.
Does OCT evidence of early stent strut coverage support shortening DAPT duration to within 3 months after DES implantation in patients with coronary artery disease?
Does OCT evidence of early stent strut coverage support shortening DAPT duration to within 3 months after DES implantation in patients with coronary artery disease?
OCT assessment of early stent strut coverage provides surrogate evidence that shortening DAPT to within 3 months after DES implantation may be a safe alternative to reduce bleeding risk.
OCT-guided early DAPT shortening may reduce bleeding; leaves open need for randomized confirmation before practice change.
INTRODUCTION: Dual antiplatelet therapy (DAPT) is required for coronary artery disease treated with drug-eluting stents (DES) implantation. Shortening DAPT duration would be beneficial for patients with high bleeding risk. AREAS COVERED: Early healing patterns, especially stent strut coverage, assessed by optical coherence tomography (OCT) as a surrogate of neointima have been investigated to make decisions on whether short DAPT would be a safe alternative. This review evaluates the OCT evidence (i.e. neointimal coverage of stent struts within 3 months) for shortening DAPT duration after DES implantation. EXPERT COMMENTARY: Shortening DAPT (i.e. within 3 months) duration after DES implantation might reduce complications including bleeding without increasing stent thrombosis. However, the optimal duration of DAPT after DES implantation is under discussion. Long-term assessment of short DAPT is required for the decision of the new guidelines regarding the recommended duration of DAPT.
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Ozaki et al. (2020) conducted a review in Coronary artery disease treated with drug-eluting stents. Shortening dual antiplatelet therapy (DAPT) duration guided by optical coherence tomography (OCT) was evaluated on Neointimal coverage of stent struts, bleeding, and stent thrombosis. Shortening dual antiplatelet therapy to within 3 months after drug-eluting stent implantation, guided by optical coherence tomography, may reduce bleeding without increasing stent thrombosis.
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