Would you continue SAPT beyond 12 months after left main stenting in an elderly patient on DOAC for paroxysmal atrial fibrillation?

Many clinical decisions like this one require tailoring the pharmacologic regimen to the individual patient. Obviously, elderly patients on a DOAC are inherently at risk for bleeding, but the risk of a left main stent thrombosis must also be considered. Clinical trials and retrospective data help us...

From the results of the AFIRE trial, the ACC Expert Consensus recommends discontinuing all antiplatelet agents in patients with atrial fibrillation and stable ischemic heart disease who are on a DOAC and are >1 year post-PCI or CABG.

LM PCI gives one a small margin for error and maintaining Clopidogr...

Beyond 1 year, if no "events" within 1 year after PCI - no benefit from extended DAPT therapy based on complex anatomy. DAPT score still informs, though.

Yeh et al., PMID 29073947

Furthermore, Dr. @Dr. First Last asututely invokes the "map is not the territory". Biography [n = 1] matters.

Krumholz, PMI...