Kalyan R Chitturi, Gregg W Stone, Roxana Mehran, Pieter C Smits, Douglas E Drachman, Dominick J Angiolillo, Grant W Reed, Usman Baber, C Michael Gibson, Ron Waksman
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Cardiovascular Research Technologies 2025: Beyond the Guidelines: DAPT selection and duration before and after PCI.
Dual antiplatelet therapy (DAPT) remains a cornerstone of secondary prevention in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS). The balance between ischemic protection and bleeding risk has driven refinements in therapy duration. In 2025, the American College of Cardiology (ACC), American Heart Association (AHA), American College of Emergency Physicians (ACEP), National Association of EMS Physicians (NAEMSP), and the Society of Cardiovascular Angiography and Interventions (SCAI) released joint guidelines on the management of patients with ACS, with a particular emphasis on DAPT duration. Considering these recently updated guidelines, the 2025 Cardiovascular Research Technologies (CRT) conference convened a session with leading interventional cardiology experts, entitled "Beyond the Guidelines - DAPT Selection and Duration Before and After PCI" to discuss implementation strategies for DAPT based on unique clinical scenarios and the new guideline recommendations. This article synthesizes the current guideline-directed recommendations and expert discussion to provide an evidence-based perspective on beyond the guidelines topics such as optimal DAPT duration, individualized de-escalation strategies, and evolving treatment paradigms for special populations.
期刊介绍：
Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.
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