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Systematic ReviewResearchMedication Safety

Ultrashort DAPT reduced bleeding after ACS PCI but requires careful selection

JACC. Cardiovascular interventions (PubMed)Sep 14, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A meta-analysis of 10 randomized trials found that no more than one month of dual antiplatelet therapy after PCI for acute coronary syndrome reduced major bleeding without increasing ischemic events overall, while important subgroup signals caution against treating all abbreviated regimens as equivalent.

What NurseJet pulled from the source

Across 29,232 participants, ultrashort DAPT reduced major bleeding (HR 0.47) and did not significantly increase the overall composite ischemic outcome (HR 1.06). However, higher ischemic risk appeared in STEMI and with the most intensive abbreviation strategies.

Why this matters for nurses

Cardiac nurses reconcile high-risk antiplatelet regimens, monitor bleeding and recurrent ischemia, and reinforce discharge plans. The findings underscore that duration and follow-on monotherapy are patient- and strategy-specific decisions.

Bedside takeaway

Treat DAPT abbreviation as a prescribed strategy, not a blanket rule after ACS PCI.

Key takeaways

  • Ultrashort DAPT reduced major bleeding compared with standard-duration therapy in the pooled analysis.
  • The overall major adverse cardiac and cerebrovascular event estimate did not differ significantly, but a higher-risk signal appeared in patients with STEMI.
  • Strategies using no more than one week of DAPT or clopidogrel or aspirin monotherapy were associated with higher ischemic risk, unlike more moderate abbreviation strategies.

Practice implications

  • Verify the prescribed DAPT duration and follow-on antiplatelet agent at every transition, assess for bleeding and recurrent ischemic symptoms, and escalate discrepancies promptly. Do not shorten, extend, or substitute antiplatelet therapy outside provider orders and the local PCI pathway.

Limitations & cautions

  • Abstract-only summary. The pooled strategies differed, net clinical benefit was heterogeneous, subgroup findings may not be definitive, and bleeding reduction differed by ethnicity in the included trials.
  • AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Public citations are filtered to exact credible source pages. Homepage-only or invalid links stay in admin review and are not shown here.

JACC. Cardiovascular interventions (PubMed)

JACC. Cardiovascular interventions (PubMed). Ultrashort vs Standard-Duration Dual Antiplatelet Therapy in Acute Coronary Syndrome Patients Undergoing PCI: A Meta-Analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42735966/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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