Can Shorter DAPT Reduce Bleeding Without Raising Cardiovascular Risk?

To determine the optimal duration of dual antiplatelet therapy (DAPT) in patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI), researchers evaluated the safety and efficacy of abbreviated DAPT (1 to 3 months) compared with standard DAPT (6 to 12 months). Researchers systematically reviewed 14 randomized controlled trials involving 11,398 patients at HBR aged 68 to 80 years. Compared with standard DAPT, abbreviated DAPT was associated with a lower risk of major or clinically relevant nonmajor bleeding (MCRB; risk ratio [RR], 0.71) and major bleeding (RR, 0.76).

However, no differences were found between the groups in the risk of major adverse cardiovascular events (MACE; a composite of cardiovascular death, myocardial infarction, or stroke; RR, 0.97) or its individual components. An increased risk of MACE was observed with 1 month of DAPT compared with…