According to the 2023 ESC guidelines on acute coronary syndromes, what is the recommended dual antiplatelet therapy (DAPT) duration after drug-eluting stent (DES) implantation for a patient with NSTEMI and no high bleeding risk?
- A 1 month
- B 6 months
- C 12 months ✓
- D 24 months
Correct answer: C. 12 months
Explanation
The 2023 ESC ACS guidelines recommend 12 months of DAPT (aspirin + P2Y12 inhibitor, preferably ticagrelor or prasugrel) following DES in ACS patients without high bleeding risk. This duration balances ischaemic protection against bleeding risk. Shortening to 6 months or even 3 months is considered only in high-bleeding-risk patients (HBR) as defined by ARC-HBR criteria. Extending beyond 12 months can be considered in very high ischaemic risk patients. 1 month is appropriate only after BMS in stable angina.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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