Individualized Duration of Dual Antiplatelet Therapy Guided by Risk Scores　― Ready for Prime Time? ―

摘要

In patients undergoing percutaneous coronary intervention(PCI) with stent implantation, dual antiplatelettherapy (DAPT), defined as the combination of aspirinand a P2Y12 inhibitor, is crucial for reducing the risk ofstent thrombosis (ST) and recurrent ischemic events.1 Theoptimal duration of DAPT after coronary stenting has beenthe object of extensive investigation.2 Prolonged DAPT hasbeen demonstrated to reduce the rate of ST and ischemicrecurrence, though increasing the risk of bleeding.3 Conversely,shorter DAPT regimens have been proved to reducebleeding, but at the cost of decreasing the protection fromischemic recurrence, especially, in patients with acutecoronary syndromes (ACS).4 In aggregate, results of trialshave demonstrated that “a one size fits all” approach is notadequate when selecting the optimal duration of DAPT,thereby mandating individualized treatment strategiesaimed at pinpointing the optimal balance between bleedingand thrombotic risks.