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Invited Commentary
May 2017

Deciding on the Duration of Dual Antiplatelet Therapy—When the Choice Between 2 Evils Is Still Evil

Author Affiliations
  • 1Department of Cardiology, Bern University Hospital, Bern, Switzerland
  • 2Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
JAMA Cardiol. 2017;2(5):488-489. doi:10.1001/jamacardio.2017.0125

The Dual Antiplatelet Therapy (DAPT) Study1 was an international, blinded, placebo-controlled, randomized trial comparing 2 durations of thienopyridine therapy to prevent stent thrombosis (ST) or the composite end point of mortality, myocardial infarction (MI), or stroke among 9961 patients treated with drug-eluting stents. The study aimed to demonstrate that prolonged thienopyridine therapy (ie, for an additional 18 months) would be noninferior to standard therapy duration (ie, 1-year therapy after coronary stenting) with respect to moderate or severe bleeding as defined by the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Arteries (GUSTO) classification.1 A secondary cohort consisting of 1687 patients treated with bare metal stents was also included.

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