TY - JOUR
T1 - Cardiovascular Research Technologies 2025
T2 - Beyond the Guidelines: DAPT selection and duration before and after PCI
AU - Chitturi, Kalyan R.
AU - Stone, Gregg W.
AU - Mehran, Roxana
AU - Smits, Pieter C.
AU - Drachman, Douglas E.
AU - Angiolillo, Dominick J.
AU - Reed, Grant W.
AU - Baber, Usman
AU - Gibson, C. Michael
AU - Waksman, Ron
N1 - Publisher Copyright:
© 2025
PY - 2025/8
Y1 - 2025/8
N2 - Dual antiplatelet therapy (DAPT) remains a cornerstone of secondary prevention in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS). The balance between ischemic protection and bleeding risk has driven refinements in therapy duration. In 2025, the American College of Cardiology (ACC), American Heart Association (AHA), American College of Emergency Physicians (ACEP), National Association of EMS Physicians (NAEMSP), and the Society of Cardiovascular Angiography and Interventions (SCAI) released joint guidelines on the management of patients with ACS, with a particular emphasis on DAPT duration. Considering these recently updated guidelines, the 2025 Cardiovascular Research Technologies (CRT) conference convened a session with leading interventional cardiology experts, entitled “Beyond the Guidelines – DAPT Selection and Duration Before and After PCI” to discuss implementation strategies for DAPT based on unique clinical scenarios and the new guideline recommendations. This article synthesizes the current guideline-directed recommendations and expert discussion to provide an evidence-based perspective on beyond the guidelines topics such as optimal DAPT duration, individualized de-escalation strategies, and evolving treatment paradigms for special populations.
AB - Dual antiplatelet therapy (DAPT) remains a cornerstone of secondary prevention in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS). The balance between ischemic protection and bleeding risk has driven refinements in therapy duration. In 2025, the American College of Cardiology (ACC), American Heart Association (AHA), American College of Emergency Physicians (ACEP), National Association of EMS Physicians (NAEMSP), and the Society of Cardiovascular Angiography and Interventions (SCAI) released joint guidelines on the management of patients with ACS, with a particular emphasis on DAPT duration. Considering these recently updated guidelines, the 2025 Cardiovascular Research Technologies (CRT) conference convened a session with leading interventional cardiology experts, entitled “Beyond the Guidelines – DAPT Selection and Duration Before and After PCI” to discuss implementation strategies for DAPT based on unique clinical scenarios and the new guideline recommendations. This article synthesizes the current guideline-directed recommendations and expert discussion to provide an evidence-based perspective on beyond the guidelines topics such as optimal DAPT duration, individualized de-escalation strategies, and evolving treatment paradigms for special populations.
KW - ACS
KW - Acute coronary syndrome
KW - DAPT
KW - Dual-antiplatelet therapy
KW - PCI
KW - Percutaneous coronary intervention
UR - https://www.scopus.com/pages/publications/105010334049
U2 - 10.1016/j.carrev.2025.06.035
DO - 10.1016/j.carrev.2025.06.035
M3 - Review article
C2 - 40651896
AN - SCOPUS:105010334049
SN - 1553-8389
VL - 77
SP - 1
EP - 6
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
ER -