{"id":8621,"date":"2025-09-13T15:29:47","date_gmt":"2025-09-13T12:29:47","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8621"},"modified":"2025-09-13T15:29:47","modified_gmt":"2025-09-13T12:29:47","slug":"reduce-dapt-to-3-months-after-mi-dual-acs-trial","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/reduce-dapt-to-3-months-after-mi-dual-acs-trial\/","title":{"rendered":"Reduce DAPT to 3 Months After MI (DUAL-ACS Trial)"},"content":{"rendered":"<div>Reduce DAPT to 3 Months After MI (DUAL-ACS Trial)<\/div>\n<div><\/div>\n<div>Source: Medscape, ESC Congress 2025 \u2013 September 11, 2025<\/div>\n<div><span> 1. Background<\/span><\/div>\n<div><span> \u2022 Current guidelines: 12 months of DAPT after MI (Class 1A).<\/span><\/div>\n<div><span> \u2022 Concern: prolonged DAPT increases bleeding and may even increase all-cause mortality.<\/span><\/div>\n<div><span> 2. Trial Design<\/span><\/div>\n<div><span> \u2022 Randomized, real-world study in ~5,000 MI patients (Scotland).<\/span><\/div>\n<div><span> \u2022 Compared 3 months DAPT \u2192 single antiplatelet vs 12 months DAPT.<\/span><\/div>\n<div><span> \u2022 Most patients received aspirin + clopidogrel\/ticagrelor.<\/span><\/div>\n<div><span> 3. Key Results<\/span><\/div>\n<div><span> \u2022 All-cause mortality: lower with 3 months (2.7%) vs 12 months (3.4%), HR 0.78 (NS).<\/span><\/div>\n<div><span> \u2022 CV death or nonfatal MI: similar (9.3% vs 8.9%).<\/span><\/div>\n<div><span> \u2022 Major bleeding: less with 3 months (3.2% vs 4.0%), HR 0.78 (NS).<\/span><\/div>\n<div><span> \u2022 Trial was underpowered (planned 17,000 but stopped at 5,000 due to COVID).<\/span><\/div>\n<div><span> 4. Interpretation<\/span><\/div>\n<div><span> \u2022 Trends support shorter DAPT duration (less bleeding, possible mortality benefit).<\/span><\/div>\n<div><span> \u2022 Consistent with meta-analyses and prior data.<\/span><\/div>\n<div><span> \u2022 \u201cLess is more\u201d \u2014 prolonged DAPT may cause harm without added efficacy.<\/span><\/div>\n<div><span> 5. Guideline Implications<\/span><\/div>\n<div><span> \u2022 Current ESC &amp; AHA\/ACC guidelines still recommend 12 months unless high bleeding risk.<\/span><\/div>\n<div><span> \u2022 Experts suggest future guidelines should consider shorter DAPT or P2Y12 monotherapy strategies.<\/span><\/div>\n<div><\/div>\n<div>Take-home message:<\/div>\n<div>While not statistically significant, DUAL-ACS adds real-world evidence that 3 months of DAPT post-MI may be enough \u2014 reducing bleeding and potentially lowering mortality \u2014 and calls into question the routine 12-month recommendation.<\/div>\n<div><\/div>\n<div><\/div>\n<div><a href=\"https:\/\/www.medscape.com\/viewarticle\/reduce-dapt-3-months-after-mi-dual-acs-2025a1000nzw\">https:\/\/www.medscape.com\/viewarticle\/reduce-dapt-3-months-after-mi-dual-acs-2025a1000nzw<\/a><\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Reduce DAPT to 3 Months After MI (DUAL-ACS Trial) Source: Medscape, ESC Congress 2025 \u2013 September 11, 2025 1. Background \u2022 Current guidelines: 12 months of DAPT after MI (Class 1A). \u2022 Concern: prolonged DAPT increases bleeding and may even increase all-cause mortality. 2. Trial Design \u2022 Randomized, real-world study in ~5,000 MI patients (Scotland). [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8621","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8621","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8621"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8621\/revisions"}],"predecessor-version":[{"id":8622,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8621\/revisions\/8622"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8621"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8621"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8621"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}