ACC 25 - Findings from a stratified study investigating coronary stenting and bleeding risk suggest 3 months are the optimal duration of DAPT after PCI.

Dr Hyo-Soo Kim (Seoul National University Hospital, KR) sits down to discuss the first randomized study stratifying patients receiving percutaneous coronary intervention with drug eluting stents according to bleeding risk based on the ARC HBR criteria, and to test different durations of dual antiplatelet therapy either in high and low bleeding risk populations. 4897 eligible patients receiving PCI were enrolled in the study from 53 centers in Korea.

Findings showed that in high bleeding risk patients, 1-month DAPT did not meet non-inferiority to 3-month DAPT for Net Adverse Clinical Events (NACE), and was inferior for NACE and MAjor Adverse Cardiac and Cerebrovascular Events (MACCE) at 1-year with no significant difference in actionable bleeding. In low bleeding risk patients, 3-month DAPT reduced any actionable bleeding without increasing NACE or MACCE as compared to 12-month DAPT. This suggests that 3 months would be the optimal duration of DAPT after PCI to meet the balance of thrombosis vs bleeding.

Interview Questions: 

1. What was the study design, patient population and endpoints?

2. What are the key outcomes?

3. How should these findings influence clinical decision making?

4. What are the next steps for further research in this area?

Recorded on-site at ACC in Chicago, 2025.

Editors: Yazmin Sadik, Jordan Rance
Videographers: Dan Brent, David Ben-Harosh

Support: This is an independent interview produced by Radcliffe Cardiology.