Why the study?
The optimal DAPT duration after PCI remains under debate, and a novel strategy of P2Y12 inhibitor monotherapy after 1 to 3 months of DAPT has been proposed.
Does P2Y12 inhibitor monotherapy after 1 to 3 months of dual antiplatelet therapy provide a safe and feasible alternative to standard 6 to 12 months of dual antiplatelet therapy in patients after percutaneous coronary intervention?
Does P2Y12 inhibitor monotherapy after 1 to 3 months of dual antiplatelet therapy provide a safe and feasible alternative to standard 6 to 12 months of dual antiplatelet therapy in patients after percutaneous coronary intervention?
This review highlights that shortening dual antiplatelet therapy to 1-3 months followed by P2Y12 inhibitor monotherapy is a feasible emerging strategy for select patients post-PCI.
Short DAPT followed by P2Y12 monotherapy may reduce bleeding after PCI; leaves open optimal duration and ischemic safety in high-risk patients.
Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor for 6-12 months is the current standard treatment for patients after percutaneous coronary intervention (PCI). However, the optimal DAPT duration is still under debate. A novel strategy with P2Y12 inhibitor monotherapy after PCI has been proposed recently. This strategy shortens the duration of DAPT to 1 to 3 months, followed by monotherapy with a P2Y12 inhibitor instead of aspirin. It has been tested in several clinical trials with promising results. In this article, we reviewed the relevant clinical trial data and the scientific rationale of P2Y12 inhibitor monotherapy with laboratory evidence of platelet inhibition. An early aspirin-free strategy with P2Y12 inhibitor monotherapy seems feasible in some of the patients after PCI.
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A 2021 study studied this question.
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