Tahir Usman A, Yeh Robert W
a Smith Center for Outcomes Research in Cardiology , Beth Israel Deaconess Medical Center , Boston , MA , USA.
Expert Rev Cardiovasc Ther. 2017 Sep;15(9):681-693. doi: 10.1080/14779072.2017.1362980. Epub 2017 Aug 9.
Improved stent technologies have lead to reduced minimum durations of dual antiplatelet therapy (DAPT) to prevent stent thrombosis. However, the anti-ischemic benefits seen in extended DAPT in both stent and non-stent related lesions have called into question the optimum duration of DAPT after stent placement. Areas covered: We review the evidence for varying durations of DAPT after drug eluting stent placement including for patients on oral anticoagulation; decision tools available for clinicians to optimize patient selection for extended therapy and insight into application of these risk assessment tools in clinical practice. Expert commentary: The use of risk assessment tools in optimizing DAPT duration after stent placement provides an opportunity for improved outcomes by means of a personalized approach to care while allowing clinicians to engage with patients in shared-decision making.
改进的支架技术已使预防支架血栓形成的双联抗血小板治疗（DAPT）最短持续时间缩短。然而，在支架相关和非支架相关病变的延长DAPT中观察到的抗缺血益处，引发了对支架置入后DAPT最佳持续时间的质疑。涵盖领域：我们回顾了药物洗脱支架置入后不同DAPT持续时间的证据，包括口服抗凝患者的证据；临床医生可用于优化患者选择以进行延长治疗的决策工具，以及对这些风险评估工具在临床实践中的应用的见解。专家评论：在优化支架置入后DAPT持续时间时使用风险评估工具，通过个性化的护理方法提供了改善预后的机会，同时使临床医生能够与患者共同参与决策。
