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DAPT Duration Personalisation

Bleeding-ischaemic risk assessment in dual antiplatelet therapy after PCI; PRECISE-DAPT and DAPT score.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is DAPT Duration Personalisation?

Dual antiplatelet therapy (DAPT) is the cornerstone treatment for the prevention of stent thrombosis and recurrent ischaemic events after percutaneous coronary intervention (PCI).

Optimal DAPT duration is determined individually based on bleeding risk (PRECISE-DAPT) and ischaemic risk (DAPT score). It can be shortened or extended in selected patients (1-30 months).

Symptoms

Recent PCI (drug-eluting stent)
Acute coronary syndrome (STEMI/NSTEMI)
Stable coronary artery disease + PCI
Need for triple antithrombotic therapy (with AF)
Active bleeding or high bleeding risk

Risk Factors

PRECISE-DAPT >25 (high bleeding risk)
DAPT score >=2 (high ischaemic benefit)
Diabetes mellitus, peripheral artery disease
Renal insufficiency, advanced age
Genetic CYP2C19 LoF variants (clopidogrel resistance)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Bleeding episode under DAPT (haematuria, melena, epistaxis)
  • DAPT shortening evaluation in PCI patient with high bleeding risk
  • Stable CAD patient with planned surgery (DAPT interruption)
  • Concomitant DAPT + OAC scenario (triple therapy)

Treatment Methods

01
Standard DAPT (12 months ASA + ticagrelor/prasugrel/clopidogrel in ACS)
02
Short DAPT (1-3 months in high bleeding risk → ASA monotherapy)
03
Extended DAPT (12-30 months in high ischaemic risk DAPT score >=2)
04
P2Y12 inhibitor monotherapy (ticagrelor 12 months alternative)
05
Triple therapy → dual therapy de-escalation (in DOAC + AF)
06
Genotype-guided strategy (CYP2C19 testing)
07
PPI addition (in patients with GI bleeding risk)
08
Annual reassessment (bleeding/ischaemic risk)

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kardiyoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.