[Efficacy and safety of dual anti-platelet aggregation short post-pharmacologic stent]

The objective of this systematic review is to evaluate the efficacy and safety of short-duration dual antiplatelet therapy (< 6 months) compared with prolonged therapy (> 12 months) following drug-eluting stent implantation. A systematic search was conducted in databases such as PubMed and Google Scholar for articles published between 2019 and 2025, focusing on randomized clinical trials, observational studies, and recent meta-analyses. The primary outcomes analyzed were major ischemic events (cardiovascular death, myocardial infarction, stent thrombosis), major bleeding, and all-cause mortality. Available evidence demonstrates that short-duration dual antiplatelet therapy is non-inferior to prolonged therapy in preventing major adverse cardiovascular events and is consistently associated with a significant reduction in the risk of major bleeding. This strategy offers a superior net clinical benefit when an individualized de-escalation approach is applied, particularly with the use of new-generation drug-eluting stents, supporting the abbreviated regimen as a viable recommendation and, for many patients at high bleeding risk, the preferred option. These findings underscore the importance of integrating ischemic-bleeding risk profiles into personalized therapeutic decision-making.