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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Dual antiplatelet therapy (DAPT) is crucial after percutaneous coronary intervention (PCI).
  • Complex PCI (C-PCI) is associated with higher ischemic risk.
  • Optimal DAPT duration in C-PCI patients is debated due to varying definitions and risks.

Purpose of the Study:

  • To review the increased risks associated with C-PCI.
  • To compare short-term versus long-term DAPT regimens in C-PCI.
  • To explore DAPT in special C-PCI cohorts and controversial issues.

Main Methods:

  • Literature review focusing on DAPT duration after C-PCI.
  • Analysis of safety and efficacy endpoints for different DAPT durations.
  • Examination of outcomes in specific C-PCI patient groups.

Main Results:

  • C-PCI is linked to elevated ischemic risk, potentially favoring longer DAPT.
  • Heterogeneity in C-PCI definitions complicates optimal DAPT strategy.
  • Limited data exists for specific C-PCI subsets and co-existing conditions like atrial fibrillation.

Conclusions:

  • Balancing ischemic and bleeding risks in C-PCI requires tailored DAPT strategies.
  • Further research is needed to define C-PCI universally and optimize DAPT duration.
  • Future studies should address specific C-PCI cohorts and antithrombotic choices.