The Optimal Duration of Dual Combination Antiplatelet Therapy After Stent Implantation and Perioperative Management Issues.

Impending risk of stent Thrombosis (ST) after percutaneous coronary intervention (PCI) has mandated post-PCI use of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor. As the optimal duration of DAPT remains controversial, premature discontinuation of it potentiates the risk of ST, myocardial infarction or death; while use of DAPT itself increases the risk of bleed. Similarly, perioperative DAPT management is still ill defined, where there is higher operative risk of bleed on antiplatelet therapy and higher ST risk during this thrombogenic period if off antiplatelet therapy. Additional clinical investigation is warranted in these fields.