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Heart disease is the leading cause of death in both men and women in The United States. Because advanced heart disease is often treated with percutaneous coronary intervention (PCI) for stent implantation, many patients will be put on dual antiplatelet therapy to prevent adverse effects such as stent thrombosis or restenosis. The purpose of this literature review is to determine if the development of second-generation drug eluting stents allows for a shorter, 6-month, duration of dual antiplatelet therapy (DAPT) versus the currently recommended 12 months. The articles discussed in this review were obtained on PubMed and narrowed using search terms such as “Dual antiplatelet therapy”, “Drug eluting stent” and “Second generation”. The Cumulative Index for Nursing and Allied Health Literature database was also searched using the same terms as above and yielded no additional articles. 3 articles were selected based on their pertinence and parameters outlined in our research question. All three articles analyzed concluded that 6 months of DAPT was non-inferior to 12 months in the prevention of adverse events such as stent thrombosis, thrombotic events such as myocardial infarction, stroke and major bleeding. While superiority of a shorter treatment duration was not supported by the findings of this literature review, we do believe the results present useful clinical benefits. Shorter DAPT duration may provide benefits to patients, such as decreased treatment costs, improved medication compliance and fewer follow up visits without increasing the risk of adverse events. It is suggested that larger studies with broader inclusion criteria and larger sample sizes be performed to adequately identify ideal treatment duration of DAPT following PCI with a second-generation drug eluting stent since the studies reviewed in this article may have been underpowered to detect existing differences.
Coy A, Murtha C. Shorter Duration of Dual Antiplatelet Therapy Following Second Generation Drug Eluting Stent Placement. 2023.