A 61-year-old woman presents 90 minutes after STEMI onset. Primary PCI is performed successfully. She is now considered for dual antiplatelet therapy (DAPT) duration. Per current AHA/ACC guidelines, the recommended minimum DAPT duration post-drug-eluting stent (DES) in stable patients without high bleeding risk is:
- A 12 months ✓
- B 6 months
- C 3 months
- D 1 month
Correct answer: A. 12 months
Explanation
Post-STEMI with drug-eluting stent, current AHA/ACC and ESC guidelines recommend 12 months of DAPT (aspirin + P2Y12 inhibitor — ticagrelor or prasugrel preferred over clopidogrel). In patients at high bleeding risk or requiring anticoagulation, shorter durations (3–6 months) may be considered after risk-benefit assessment. The 1-month duration applies only to bare-metal stents in specific high-risk bleeding situations.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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