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DAPT reduction

DAPT reduction is a clinical strategy to shorten the duration of dual antiplatelet therapy (aspirin plus P2Y12 inhibitor) after percutaneous coronary intervention.

DAPT reduction is a clinical strategy to shorten the duration of dual antiplatelet therapy (aspirin plus P2Y12 inhibitor) after percutaneous coronary intervention. Used for Reduction of bleeding risk in high-bleeding-risk patients undergoing percutaneous coronary intervention with stent placement, Patients requiring urgent surgery or procedures incompatible with prolonged antiplatelet therapy.

At a glance

Mechanism of action

Rather than a single drug, DAPT reduction refers to protocols that limit dual antiplatelet therapy to shorter periods (typically 1–3 months instead of 12 months) in selected patients undergoing coronary stent placement. This approach aims to reduce bleeding complications while maintaining efficacy in preventing stent thrombosis, particularly in high-bleeding-risk patients or those requiring urgent surgery.

Approved indications

• Reduction of bleeding risk in high-bleeding-risk patients undergoing percutaneous coronary intervention with stent placement
• Patients requiring urgent surgery or procedures incompatible with prolonged antiplatelet therapy

Common side effects

• Stent thrombosis
• Myocardial infarction
• Bleeding reduction (benefit, not adverse event)

Key clinical trials

• SIMPLAAFY Clinical Trial (NA)
• Tailoring Bleeding Reduction Approaches in Patients Undergoing PCI (PHASE4)
• Prasugrel Monotherapy Reduced Dose in Acute and Chronic Coronary Syndrome Patients After Percutaneous Coronary Intervention (PROMOTE) (PHASE4)
• PCI With Guideline-Directed Medical Therapy for HFpEF Patients With Ischemic Cardiomyopathy (NA)
• Anti-inflammatory Therapy for Recurrent In-stent Restenosis (PHASE4)
• Comparison Of Reduced DAPT Followed by P2Y12 Inhibitor Monotherapy With Prasugrel vs stAndard Regimen in STEMI Patients (PHASE4)
• Comparison of Dual Antiplatelet Therapy De-escalation by Dose Reduction Versus Switching in Patients Undergoing PCI: The Switching Antiplatelet-8 (SWAP-8) Study (PHASE4)
• The Effect of Atorvastatin 80 mg on Hs-CRP/Albumin Ratio in Reducing Thrombus Burden in PCI-STEMI Patients (NA)

Primary sources

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