Effectiveness of Dual Antiplatelet Therapy (DAPT) Duration (6 vs. 12 Months) Following Drug-Eluting Stent Implantation in Patients with Acute Coronary Syndrome

Author(s): Arhum Mahmood, Rutvij Patel, Fnu Samiah, Muna Hamad, Achbari Samia, Huseyin Erdem AK, Pendyala Seetharam, Imdad Ullah

The objective of this systematic review and meta-analysis was to quantitatively synthesize a body of literature regarding the effects of a six months versus twelve months of dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS) undergoing drug-eluting stent implantation (DES) intervention. The major clinical end points used in this study included stent thrombosis or myocardial infarction, stroke, allcause mortality, and major bleeding. Out of a total 1,560 articles reviewed, only 13 articles met the inclusion criteria, including randomized controlled trials (RCTs), cohort studies, and observational studies. The comparison between the groups revealed that 12-month DAPT was more effective in decreasing stent thrombosis but was also credited to the rise in the deaths caused by major bleeding. Myocardial infarction and stroke rates did not differ significantly between the two DAPT durations, and there were no significant differences in all-cause mortality. Therefore, these observations underscore the importance of tailoring individual patient care and deciding whether the increased risk of thrombotic events requires a prolonged DAPT period or if the concurrent risk of bleeding outweighs this potential benefit.