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[Comment] Tailoring duration of DAPT with risk scores

Dual antiplatelet therapy (DAPT) reduces stent thrombosis and ischaemic events after percutaneous coronary intervention (PCI), but increases the risk of bleeding.1 Current guidelines recommend default DAPT durations of 6 months and 12 months for patients undergoing elective PCI and those presenting with acute coronary syndromes, respectively, but also leave ample room for shortening or extending the duration of DAPT based on the individual’s risks of ischaemia and bleeding.2,3 Ideally, it would be desirable for physicians to personalise the duration of DAPT based on a prediction rule that easily identifies patients at high bleeding risk and separates patients who benefit from shortening DAPT (eg, high bleeding risk and low risk of ischaemia) versus prolonging DAPT (eg, non-high bleeding risk and high risk of ischaemia).

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