Beyond 12 Months: Extended DAPT in Multivessel CAD — The DAPT-MVD Trial (NEJM 2026)
Beyond 12 Months: Extended DAPT in Multivessel CAD — The DAPT-MVD Trial (NEJM 2026)
Published: 15 July 2026
Key Points
• In the DAPT-MVD randomized trial, 8,250 patients with multivessel coronary artery disease who remained event-free for 12 months after drug-eluting stent implantation were enrolled.
• Patients received either clopidogrel plus aspirin for an additional 12 months or aspirin alone.
• Extended DAPT reduced cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke: 5.8% vs 6.8% at 36 months.
• This represented an 18% relative reduction in the primary ischemic outcome.
• Nonfatal myocardial infarction was reduced by approximately 32%.
• Clinically relevant or major bleeding was similar: 1.4% vs 1.5%.
• The findings apply mainly to selected patients with high ischemic risk and low bleeding risk who tolerated the first year of DAPT without major events.
• The results should not be generalized automatically to elderly patients, those at high bleeding risk, or patients requiring anticoagulation.
Source: Tian J, Wang Z, Wang Y, et al.; DAPT-MVD Trial Investigators. Extended Dual Antiplatelet Therapy for Multivessel Coronary Artery Disease. New England Journal of Medicine.
Citation: N Engl J Med. 2026;395:233–242.
DOI / Link: https://doi.org/10.1056/NEJMoa2517588