Optimal DAPT Duration after PCI in ACS

The current analysis is an observational, retrospective cohort study conducted at a single location between October 2013 and February 2017 on patients with ACS who underwent emergency PCI with DES at the First Affiliated Hospital of Xi'an Jiaotong University, Yanta. The inclusion criteria of the current analysis are as follows: (1) patients between the age of 18 and 80 years; (2) patients with ACS who received DAPT for 12–24 months and who had no clinical ischemic or bleeding events during the first 12 months; and (3) patients who successfully underwent emergency PCI with DES. A total of 3,236 patients with ACS were investigated. The exclusion criteria for this study are as follows: (1) a history of coronary artery bypass grafting, cardiogenic shock, malignant tumor, significant infection, or autoimmune disease; (2) a renal disorder with an estimated glomerular filtration rate (eGFR) of < 30 mL/min/1.73 m²) or accepted renal replacement treatment; (3) hepatic dysfunction with aspartate transaminase or alanine transaminase levels greater than five upper limits of normal; (4) non-obstructive coronary disease, primary cardiomyopathy, and valvular heart disease; (5) heart failure with left ventricular ejection fraction (LVEF) <30%; (6) oral anticoagulants during follow-up; (7) anemia with hemoglobin (Hb) <60 g/L; (8) a history of gastrointestinal bleeding and hemorrhagic stroke; and (9) missing clinical data. A total of 987 patients were excluded following the exclusion criteria. Finally, 2,249 patients were included in the group. If DAPT was continued for 12 or 12–24 months, it was classified as the standard (n = 1,011) or prolonged (n = 1,238) DAPT group. The duration of the prolonged DAPT group is 22 (20, 24) months (Figure 1).