A patient presents with anterior STEMI and undergoes primary PCI with drug-eluting stent placement. Dual antiplatelet therapy (DAPT) with aspirin and ticagrelor is prescribed. When is it appropriate to discontinue the P2Y12 inhibitor in an uncomplicated patient at standard bleeding risk?
- A After 1 month
- B After 12 months ✓
- C After 6 months
- D After 24 months
Correct answer: B. After 12 months
Explanation
Current ACC/AHA and ESC guidelines recommend 12 months of DAPT after ACS with drug-eluting stent implantation in patients at standard bleeding risk. Shorter duration (3–6 months) may be considered in high bleeding risk patients, while extended DAPT beyond 12 months can be considered in patients with high ischemic risk and low bleeding risk (as supported by the DAPT and PEGASUS-TIMI 54 trials).
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.