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Cardiovascular Research Technologies 2025: Beyond the Guidelines: DAPT selection and duration before and after PCI
Kalyan R Chitturi1, Gregg W Stone2, Roxana Mehran2
1Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
Summary
New 2025 guidelines refine dual antiplatelet therapy (DAPT) duration after percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS). Experts discuss optimizing DAPT selection and duration beyond guidelines for individual patient needs.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Guidelines
Background:
- Dual antiplatelet therapy (DAPT) is crucial for secondary prevention post-percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS).
- Balancing ischemic protection against bleeding risk necessitates careful consideration of DAPT duration.
- Recent 2025 guidelines from major cardiology organizations address ACS management, including DAPT strategies.
Purpose of the Study:
- To synthesize current guideline-directed recommendations for DAPT duration post-PCI for ACS.
- To present expert discussions on implementing DAPT strategies beyond established guidelines.
- To explore individualized de-escalation and evolving treatment paradigms for special populations.
Main Methods:
- Review of the 2025 ACC/AHA/ACEP/NAEMSP/SCAI joint guidelines on ACS management.
- Synthesis of expert insights from the 2025 Cardiovascular Research Technologies (CRT) conference session.
- Analysis of clinical scenarios to inform DAPT selection and duration.
Main Results:
- The 2025 guidelines emphasize updated recommendations for DAPT duration in ACS patients undergoing PCI.
- Expert discussions highlighted the need for individualized DAPT strategies beyond standard recommendations.
- Consideration of unique clinical scenarios and special populations is key for optimal DAPT management.
Conclusions:
- Optimal DAPT duration requires balancing efficacy and safety, guided by new 2025 recommendations.
- Individualized de-escalation strategies and tailored approaches are essential for managing DAPT in diverse patient groups.
- The evolving treatment landscape necessitates continuous evaluation of DAPT protocols post-PCI for ACS.
Keywords:
ACSAcute coronary syndromeDAPTDual-antiplatelet therapyPCIPercutaneous coronary interventionMore Related Videos
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