STEMI vs. NSTEMI vs. STABLE CAD Post PCI Optimal DAPT …
STEMI vs. NSTEMI vs. STABLE CAD ? Post PCI Optimal DAPT Duration:
Scoring the Complexity of Stenting and Disease
Robert W. Yeh, MD MSc FACC Smith Center for Outcomes Research in Cardiology
Beth Israel Deaconess Medical Center Harvard Medical School
DAPT Guidelines
Stable CAD
ACS
2014 ESC/EACTS Guidelines on Myocardial Revascularization 2016 ACC/AHA Updated Guidelines on Dual Antiplatelet Therapy
The challenge of separating bleeding and ischemic risk
The DAPT Study Results
Risk Difference (Continued Thienopyridine ? Placebo),
12-30M
? In the DAPT Study, continuation of dual antiplatelet therapy beyond 12 months reduced
ischemic complications after coronary stenting compared with aspirin alone, yet increased
moderate or severe bleeding.
Stent
Death, MI, Myocardial GUSTO
Death
3.0% Thrombosis
2.0%
HR 0.29 1.0% (0.17?0.48)
Or Stroke (MACCE)
HR 0.71 (0.59?0.85)
Infarction
HR 0.47 (0.37?0.61)
P ................
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