New guidelines on duration of dual antiplatelet therapy in patients with coronary artery disease: what's the novelty?

The “2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients with Coronary Artery Disease” is a thorough consensus on duration of dual antiplatelet therapy (DAPT) in patients with coronary artery disease dealing with a large scope of different specific situations (1). One may ask if a new, long manuscript of 96 pages including the Supplements was necessary given the large amount of randomized clinical trials, meta-analyses, commentaries, editorials already recently published in this field. Undoubtedly, the answer is yes for several reasons. First, because some very recent trials have been published after the formulation of the latest recommendations for duration of DAPT in prior guidelines (2). Secondly, because after the extensive reading of these new guidelines, the reader will probably have a better understanding of the current knowledge according to the different situations he will have to deal with. The goal of these new guidelines was to update, harmonize and simplify recommendations on duration of DAPT in patients with coronary artery disease. Among the different clinical circumstances, the most debated one is the optimal duration of DAPT after drug-eluting stents (DES) (3). It is also a very frequent question in every day clinical practice because the implantation of (DES) has become a standard treatment for the management of patients with coronary artery disease. Millions of patients worldwide undergo coronary stenting each year.