Ozaki Y, Garcia-Garcia HM, Mintz GS, Waksman R. Supporting evidence from optical coherence tomography for shortening dual antiplatelet therapy after drug-eluting stents implantation.
Expert Rev Cardiovasc Ther 2020;
18:261-267. [PMID:
32321328 DOI:
10.1080/14779072.2020.1759421]
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Abstract
INTRODUCTION
Dual antiplatelet therapy (DAPT) is required for coronary artery disease treated with drug-eluting stents (DES) implantation. Shortening DAPT duration would be beneficial for patients with high bleeding risk.
AREAS COVERED
Early healing patterns, especially stent strut coverage, assessed by optical coherence tomography (OCT) as a surrogate of neointima have been investigated to make decisions on whether short DAPT would be a safe alternative. This review evaluates the OCT evidence (i.e. neointimal coverage of stent struts within 3 months) for shortening DAPT duration after DES implantation.
EXPERT COMMENTARY
Shortening DAPT (i.e. within 3 months) duration after DES implantation might reduce complications including bleeding without increasing stent thrombosis. However, the optimal duration of DAPT after DES implantation is under discussion. Long-term assessment of short DAPT is required for the decision of the new guidelines regarding the recommended duration of DAPT.
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