Duration of Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention With Drug-eluting Stents

The introduction of drug-eluting stents represented a significant advancement in interventional cardiology, offering a solution to the long-standing problem of restenosis after coronary revascularization. At present, drug-eluting stents are being used in a majority of stent procedures. However, they are mechanistically prone to develop late stent thrombosis and require prolonged therapy with aspirin and a thienopyridine to prevent this complication. Adequate evidence regarding the optimal duration of dual antiplatelet therapy is lacking, and the initial guidelines on this issue were framed empirically in the absence of robust data from clinical trials and analyses. In this article, we briefly review the evolution of dual antiplatelet therapy and discuss the findings from some recent analyses that test both the efficacy as well as the safety of extended and intensive platelet inhibition with aspirin and thienopyridines.