Why the study?
Prolonged DAPT after PCI increases major bleeding risk and mortality, prompting the need to summarize evidence on evolving DAPT regimens with new-generation DES and propose a practical algorithm to personalize therapy based on bleeding and ischemic risks.
Does short-duration DAPT followed by P2Y12 inhibitor monotherapy balance ischemic and bleeding risks in patients undergoing PCI with new-generation DES compared to prolonged DAPT?
Design
Narrative review of the literature (2015–2026)
Key result
Shortening dual antiplatelet therapy to 1 to 3 months followed by P2Y12 inhibitor monotherapy is a validated strategy for patients with new-generation drug-eluting stents at high bleeding risk.
Authors
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Shorter DAPT post-DES reduces bleeding without excess thrombosis; confirms consensus on individualized regimens after PCI.
Does short-duration DAPT followed by P2Y12 inhibitor monotherapy balance ischemic and bleeding risks in patients undergoing PCI with new-generation DES compared to prolonged DAPT?
The paradigm of DAPT duration has shifted to personalized medicine, where short DAPT strategies are safe and effective for patients with new-generation DES, especially those at high bleeding risk.
Mukhamedkali et al. (2026) conducted a review in Acute coronary syndromes and stable ischemic heart disease. Short-duration dual antiplatelet therapy (1 to 3 months) vs. Prolonged dual antiplatelet therapy (≥12 months) was evaluated. Shortening dual antiplatelet therapy to 1 to 3 months followed by P2Y12 inhibitor monotherapy is a validated strategy for patients with new-generation drug-eluting stents at high bleeding risk.