DAPT Trial design: Patients undergoing DES/BMS PCI, no ischemic/bleeding complications, and with documented compliance at 1 year, were randomized to receive.

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DAPT Trial design: Patients undergoing DES/BMS PCI, no ischemic/bleeding complications, and with documented compliance at 1 year, were randomized to receive another 18 months of dual antiplatelet therapy (DAPT) or placebo. Patients were followed for 18 months. Results (p < 0.001) (p = 0.72) DES PCI: MACCE for DAPT vs. placebo: 4.3% vs. 5.9%, p < 0.001; MI: 2.1% vs. 4.1%, p < 0.001; stent thrombosis: 0.4% vs. 1.4%, p < 0.001; all-cause mortality: 2.0% vs. 1.5%, p = 0.05; GUSTO moderate/severe bleeding: 2.5% vs. 1.6%, p = 0.001 BMS PCI: MACCE for DAPT vs. placebo: 4.0% vs. 4.7%, p = 0.72; MI: 2.7% vs. 3.1%, p = 0.74; stent thrombosis: 0.5% vs. 1.1%, p = 0.24; all-cause mortality: 1% vs. 1.2%, p = 0.83 % % Conclusions Prolonged DAPT ~30 months following DES PCI results in lower stent thrombosis/recurrent MIs compared with 12-month DAPT, although bleeding and all-cause mortality were higher; BMS subset showed a less impressive treatment effect Unclear to what extent this trial will immediately impact clinical practice; further follow-up and data from other ongoing trials are awaited MACCE DAPT DES PCI (n = 5,020) Placebo DES PCI (n = 4,941) DAPT BMS PCI (n = 842) Placebo BMS PCI (n = 845) Mauri L, et al. N Engl J Med 2014;371:2155-66