What is the typical antiplatelet therapy strategy after coronary stenting?

• A. Dual antiplatelet therapy (aspirin plus a P2Y12 inhibitor) for a duration determined by stent type and clinical scenario.
• B. Single antiplatelet therapy.
• C. No antiplatelet therapy.
• D. Triple therapy including anticoagulant.

Answer: (A)

After coronary stenting, preventing stent thrombosis relies on dual antiplatelet therapy: aspirin plus a P2Y12 inhibitor. Using two antiplatelet mechanisms together greatly reduces the risk of clotting on the stent in the vulnerable period after implantation.

The duration of this therapy isn’t fixed; it’s tailored to the type of stent and the patient’s clinical situation. Bare-metal stents typically require a shorter course of DAPT, while drug-eluting stents need longer treatment, commonly around 6 to 12 months, with adjustments based on bleeding risk and other factors. Some patients may continue beyond the standard period or shorten the course if bleeding risk is high or if surgery is needed.

Single antiplatelet therapy alone is not adequate to protect against stent thrombosis in the post-stent period, and no antiplatelet therapy would pose a high risk for clot formation on the stent. Triple therapy including an anticoagulant is not the routine strategy after stenting due to excessive bleeding risk unless there is another separate indication for anticoagulation.