A 62-year-old man is admitted with NSTEMI. He is treated with aspirin, ticagrelor, anticoagulation, and an early invasive strategy. Coronary angiography reveals a 95% stenosis of the proximal LAD. PCI is performed with a drug-eluting stent. What is the minimum recommended duration of dual antiplatelet therapy (DAPT) per current ESC guidelines after DES implantation for ACS?
- A 12 months ✓
- B 1 month
- C 6 months
- D 24 months
Correct answer: A. 12 months
Explanation
ESC 2020 NSTE-ACS guidelines recommend 12 months of DAPT (aspirin + P2Y12 inhibitor) after DES implantation in ACS, unless high bleeding risk necessitates shortening. This duration is based on evidence from trials including PLATO (ticagrelor vs clopidogrel). Six months may be considered in high bleeding-risk patients. Twenty-four months offers marginal ischaemic benefit but significantly increases bleeding.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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