{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:02:27Z","timestamp":1792598547788,"version":"4.5.0"},"reference-count":105,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Dual antiplatelet therapy (DAPT) remains a key element of secondary prevention after percutaneous coronary intervention. However, its optimal duration and intensity continue to pose challenges due to the trade-off between ischaemic protection and bleeding risk. Over the past decade, evidence has progressively emerged for strategies of DAPT modulation, with particular emphasis on de-escalation approaches. Randomized trials have consistently shown that reducing antiplatelet intensity, whether by lowering the dose, discontinuing one drug, or switching to a less potent agent, can mitigate bleeding events without jeopardizing ischaemic outcomes in selected patients. In contrast, escalation strategies have received less widespread adoption, reflecting more limited evidence, weaker guideline support, and the fact that most contemporary patients are at greater risk of bleeding than thrombosis. This review aims to summarize the evidence supporting DAPT modulation strategies, to critically appraise available trials, and to highlight ongoing studies in the field.<\/jats:p>","DOI":"10.1093\/ehjacc\/zuaf173","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T12:32:17Z","timestamp":1767357137000},"page":"318-336","source":"Crossref","is-referenced-by-count":3,"title":["Dual antiplatelet therapy escalation and de-escalation"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2926-9428","authenticated-orcid":false,"given":"Antonio","family":"Greco","sequence":"first","affiliation":[{"name":"Azienda Ospedaliero-Universitaria Policlinico \u2018G. Rodolico\u2014San Marco\u2019, University of Catania , Via Santa Sofia, 78, Catania 95123 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacinto","family":"Di Leo","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero-Universitaria Policlinico \u2018G. Rodolico\u2014San Marco\u2019, University of Catania , Via Santa Sofia, 78, Catania 95123 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Finocchiaro","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero-Universitaria Policlinico \u2018G. Rodolico\u2014San Marco\u2019, University of Catania , Via Santa Sofia, 78, Catania 95123 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Imbesi","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero-Universitaria Policlinico \u2018G. Rodolico\u2014San Marco\u2019, University of Catania , Via Santa Sofia, 78, Catania 95123 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5156-7723","authenticated-orcid":false,"given":"Davide","family":"Capodanno","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero-Universitaria Policlinico \u2018G. Rodolico\u2014San Marco\u2019, University of Catania , Via Santa Sofia, 78, Catania 95123 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"2026042812515510000_zuaf173-B1","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1016\/j.jacc.2024.11.009","article-title":"2025 ACC\/AHA\/ACEP\/NAEMSP\/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"85","author":"Rao","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"2026042812515510000_zuaf173-B2","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1161\/CIR.0000000000001168","article-title":"2023 AHA\/ACC\/ACCP\/ASPC\/NLA\/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association\/American College of Cardiology joint committee on clinical practice guidelines","volume":"148","author":"Virani","year":"2023","journal-title":"Circulation"},{"key":"2026042812515510000_zuaf173-B3","first-page":"55","article-title":"2023 ESC Guidelines for the management of acute coronary syndromes: developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC)","volume":"13","author":"Byrne","year":"2023","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"2026042812515510000_zuaf173-B4","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","article-title":"2024 ESC Guidelines for the management of chronic coronary syndromes: developed by the task force for the management of chronic coronary syndromes of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Vrints","year":"2024","journal-title":"Eur Heart J"},{"key":"2026042812515510000_zuaf173-B5","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1080\/14740338.2023.2245331","article-title":"Gender differences in efficacy and safety of antiplatelet strategies for acute coronary syndromes","volume":"22","author":"Occhipinti","year":"2023","journal-title":"Expert Opin Drug Saf"},{"key":"2026042812515510000_zuaf173-B6","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1093\/eurheartj\/ehac713","article-title":"Dual antiplatelet therapy in patients at high bleeding risk: less is more-more or less","volume":"44","author":"Capodanno","year":"2023","journal-title":"Eur Heart J"},{"key":"2026042812515510000_zuaf173-B7","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1161\/CIRCULATIONAHA.123.064473","article-title":"Defining strategies of modulation of antiplatelet therapy in patients with coronary artery disease: a consensus document from the academic research consortium","volume":"147","author":"Capodanno","year":"2023","journal-title":"Circulation"},{"key":"2026042812515510000_zuaf173-B8","first-page":"804","article-title":"Trade-off of myocardial infarction vs. Bleeding types on mortality after acute coronary syndrome: lessons from the thrombin receptor antagonist for clinical event reduction in acute coronary syndrome (TRACER) randomized trial","volume":"38","author":"Valgimigli","year":"2016","journal-title":"Eur Heart J"},{"key":"2026042812515510000_zuaf173-B9","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ahj.2019.10.001","article-title":"Average daily ischemic versus bleeding risk in patients with ACS undergoing PCI: insights from the BleeMACS and RENAMI registries","volume":"220","author":"D'Ascenzo","year":"2020","journal-title":"Am Heart J"},{"key":"2026042812515510000_zuaf173-B10","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1055\/s-0038-1649519","article-title":"Risk stratification for bleeding in the elderly with acute coronary syndrome: not so simple","volume":"118","author":"Capodanno","year":"2018","journal-title":"Thromb Haemost"},{"key":"2026042812515510000_zuaf173-B11","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jacasi.2022.10.008","article-title":"Shortening dual antiplatelet therapy duration in high-risk patients undergoing percutaneous coronary intervention","volume":"3","author":"Greco","year":"2023","journal-title":"JACC Asia"},{"key":"2026042812515510000_zuaf173-B12","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1016\/j.jcin.2023.08.037","article-title":"Short dual antiplatelet therapy in high bleeding risk patients: 1 month or 3 months?","volume":"16","author":"Capodanno","year":"2023","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B13","doi-asserted-by":"crossref","first-page":"133542","DOI":"10.1016\/j.ijcard.2025.133542","article-title":"Duration of dual antiplatelet therapy in patients undergoing percutaneous coronary intervention for bifurcation lesions: insights from the ULTRA-BIFURCAT registry","volume":"438","author":"Nebiolo","year":"2025","journal-title":"Int J Cardiol"},{"key":"2026042812515510000_zuaf173-B14","doi-asserted-by":"crossref","unstructured":"Costa F, van Klaveren D, James S, Heg D, R\u00e4ber L, Feres F, et al \u00a0Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: a pooled analysis of individual-patient datasets from clinical trials. Lancet \u00a02017;389:1025\u20131034.","DOI":"10.1016\/S0140-6736(17)30397-5"},{"key":"2026042812515510000_zuaf173-B15","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1001\/jama.2016.3775","article-title":"Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention","volume":"315","author":"Yeh","year":"2016","journal-title":"JAMA"},{"key":"2026042812515510000_zuaf173-B16","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1161\/CIRCULATIONAHA.124.072009","article-title":"Derivation and validation of the PRECISE-HBR score to predict bleeding after percutaneous coronary intervention","volume":"151","author":"Gragnano","year":"2025","journal-title":"Circulation"},{"key":"2026042812515510000_zuaf173-B17","doi-asserted-by":"crossref","first-page":"e013450","DOI":"10.1161\/CIRCINTERVENTIONS.123.013450","article-title":"Navigating the course of dual antiplatelet therapy after percutaneous coronary intervention: a review of guided approaches","volume":"16","author":"Ammirabile","year":"2023","journal-title":"Circ Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B18","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1056\/NEJMoa2102137","article-title":"Comparative effectiveness of aspirin dosing in cardiovascular disease","volume":"384","author":"Jones","year":"2021","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B19","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1056\/NEJMoa0909475","article-title":"Dose comparisons of clopidogrel and aspirin in acute coronary syndromes","volume":"363","author":"CURRENT-OASIS 7 Investigators","year":"2010","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B20","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1056\/NEJMoa1209979","article-title":"Bedside monitoring to adjust antiplatelet therapy for coronary stenting","volume":"367","author":"Collet","year":"2012","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B21","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1001\/jama.2011.290","article-title":"Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial","volume":"305","author":"Price","year":"2011","journal-title":"JAMA"},{"key":"2026042812515510000_zuaf173-B22","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1056\/NEJMoa1409312","article-title":"Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents","volume":"371","author":"Mauri","year":"2014","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B23","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1056\/NEJMoa1500857","article-title":"Long-term use of ticagrelor in patients with prior myocardial infarction","volume":"372","author":"Bonaca","year":"2015","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B24","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1056\/NEJMoa1908077","article-title":"Ticagrelor in patients with stable coronary disease and diabetes","volume":"381","author":"Steg","year":"2019","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B25","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/S0140-6736(19)31887-2","article-title":"Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial","volume":"394","author":"Bhatt","year":"2019","journal-title":"The Lancet"},{"key":"2026042812515510000_zuaf173-B26","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.amjcard.2023.04.036","article-title":"Eligibility to intensified antithrombotic regimens for secondary prevention in patients who underwent percutaneous coronary intervention","volume":"199","author":"Greco","year":"2023","journal-title":"Am J Cardiol"},{"key":"2026042812515510000_zuaf173-B27","doi-asserted-by":"crossref","first-page":"e008649","DOI":"10.1161\/CIRCINTERVENTIONS.119.008649","article-title":"Randomized comparison of intensified and standard P2Y(12)-receptor-inhibition before elective percutaneous coronary intervention: the SASSICAIA trial","volume":"13","author":"Mehilli","year":"2020","journal-title":"Circ Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B28","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1016\/S0140-6736(20)32236-4","article-title":"Ticagrelor versus clopidogrel in elective percutaneous coronary intervention (ALPHEUS): a randomised, open-label, phase 3b trial","volume":"396","author":"Silvain","year":"2020","journal-title":"Lancet"},{"key":"2026042812515510000_zuaf173-B29","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf652","article-title":"Temporal modulation of antiplatelet therapy in high-risk patients undergoing complex percutaneous coronary intervention: the TAILORED-CHIP randomized clinical trial","author":"Kang","year":"2025","journal-title":"Eur Heart J"},{"key":"2026042812515510000_zuaf173-B30","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1016\/j.jacc.2012.02.026","article-title":"A randomized trial of prasugrel versus clopidogrel in patients with high platelet reactivity on clopidogrel after elective percutaneous coronary intervention with implantation of drug-eluting stents: results of the TRIGGER-PCI (testing platelet reactivity in patients undergoing elective stent placement on clopidogrel to guide alternative therapy with prasugrel) study","volume":"59","author":"Trenk","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2026042812515510000_zuaf173-B31","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1093\/ehjcvp\/pvz059","article-title":"Personalized antiplatelet therapy guided by a novel detection of platelet aggregation function in stable coronary artery disease patients undergoing percutaneous coronary intervention: a randomized controlled clinical trial","volume":"6","author":"Zheng","year":"2020","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"2026042812515510000_zuaf173-B32","doi-asserted-by":"crossref","first-page":"e002640","DOI":"10.1161\/CIRCGEN.119.002640","article-title":"Prospective CYP2C19 genotyping to guide antiplatelet therapy following percutaneous coronary intervention: a pragmatic randomized clinical trial","volume":"13","author":"Tuteja","year":"2020","journal-title":"Circ Genom Precis Med"},{"key":"2026042812515510000_zuaf173-B33","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1001\/jama.2020.12443","article-title":"Effect of genotype-guided oral P2Y12 inhibitor selection vs conventional clopidogrel therapy on ischemic outcomes after percutaneous coronary intervention: the TAILOR-PCI randomized clinical trial","volume":"324","author":"Pereira","year":"2020","journal-title":"JAMA"},{"key":"2026042812515510000_zuaf173-B34","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.jcin.2023.01.356","article-title":"Genetic-guided oral P2Y(12) inhibitor selection and cumulative ischemic events after percutaneous coronary intervention","volume":"16","author":"Ingraham","year":"2023","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B35","first-page":"344","article-title":"Personalized treatment of patients with coronary artery disease: the value and limitations of predictive models","volume":"12","author":"Greco","year":"2025","journal-title":"J Cardiovasc Dev Dis"},{"key":"2026042812515510000_zuaf173-B36","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.jcin.2020.01.226","article-title":"Derivation, validation, and prognostic utility of a prediction rule for nonresponse to clopidogrel","volume":"13","author":"Angiolillo","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B37","doi-asserted-by":"crossref","first-page":"e796","DOI":"10.4244\/EIJ-D-25-00331","article-title":"One-month dual antiplatelet therapy followed by prasugrel monotherapy at a reduced dose: the 4D-ACS randomised trial","volume":"21","author":"Jang","year":"2025","journal-title":"EuroIntervention"},{"key":"2026042812515510000_zuaf173-B38","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1161\/CIRCULATIONAHA.111.059022","article-title":"Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: the efficacy of Xience\/promus versus cypher to reduce late loss after stenting (EXCELLENT) randomized, multicenter study","volume":"125","author":"Gwon","year":"2012","journal-title":"Circulation"},{"key":"2026042812515510000_zuaf173-B39","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.jacc.2012.06.043","article-title":"A new strategy for discontinuation of dual antiplatelet therapy: the RESET trial (REal safety and efficacy of 3-month dual antiplatelet therapy following endeavor zotarolimus-eluting stent implantation)","volume":"60","author":"Kim","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2026042812515510000_zuaf173-B40","first-page":"2510","article-title":"Three vs twelve months of dual antiplatelet therapy after zotarolimus-eluting stents","volume":"310","author":"Feres","year":"2013","journal-title":"JAMA"},{"key":"2026042812515510000_zuaf173-B41","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1016\/j.jacc.2014.09.008","article-title":"Second-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy: the SECURITY randomized clinical trial","volume":"64","author":"Colombo","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026042812515510000_zuaf173-B42","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.jacc.2014.11.008","article-title":"6- versus 24-month dual antiplatelet therapy after implantation of drug-eluting stents in patients nonresistant to aspirin","volume":"65","author":"Gilard","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2026042812515510000_zuaf173-B43","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1093\/eurheartj\/ehu523","article-title":"ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting","volume":"36","author":"Schulz-Schupke","year":"2015","journal-title":"Eur Heart J"},{"key":"2026042812515510000_zuaf173-B44","doi-asserted-by":"crossref","first-page":"e003145","DOI":"10.1161\/CIRCINTERVENTIONS.115.003145","article-title":"Six versus 12 months of dual antiplatelet therapy after implantation of biodegradable polymer sirolimus-eluting stent: randomized substudy of the I-LOVE-IT 2 trial","volume":"9","author":"Han","year":"2016","journal-title":"Circ Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B45","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1001\/jamacardio.2016.2811","article-title":"Prolonged vs short duration of dual antiplatelet therapy after percutaneous coronary intervention in patients with or without peripheral arterial disease: a subgroup analysis of the PRODIGY randomized clinical trial","volume":"1","author":"Franzone","year":"2016","journal-title":"JAMA Cardiol"},{"key":"2026042812515510000_zuaf173-B46","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.jcin.2016.04.036","article-title":"6-Month versus 12-month dual-antiplatelet therapy following long everolimus-eluting stent implantation","volume":"9","author":"Hong","year":"2016","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B47","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.jcin.2017.04.019","article-title":"Dual antiplatelet therapy for 6 versus 18 months after biodegradable polymer drug-eluting stent implantation","volume":"10","author":"Nakamura","year":"2017","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B48","doi-asserted-by":"crossref","first-page":"k3793","DOI":"10.1136\/bmj.k3793","article-title":"Six months versus 12 months dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction (DAPT-STEMI): randomised, multicentre, non-inferiority trial","volume":"363","author":"Kedhi","year":"2018","journal-title":"BMJ"},{"key":"2026042812515510000_zuaf173-B49","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1016\/S0140-6736(18)30493-8","article-title":"6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial","volume":"391","author":"Hahn","year":"2018","journal-title":"Lancet"},{"key":"2026042812515510000_zuaf173-B50","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.4244\/EIJ-D-17-00792","article-title":"Safety of six-month dual antiplatelet therapy after second-generation drug-eluting stent implantation: OPTIMA-C randomised clinical trial and OCT substudy","volume":"13","author":"Lee","year":"2018","journal-title":"EuroIntervention"},{"key":"2026042812515510000_zuaf173-B51","doi-asserted-by":"crossref","first-page":"e990","DOI":"10.4244\/EIJ-D-19-00539","article-title":"Final results of the randomised evaluation of short-term dual antiplatelet therapy in patients with acute coronary syndrome treated with a new-generation stent (REDUCE trial)","volume":"15","author":"De Luca","year":"2019","journal-title":"EuroIntervention"},{"key":"2026042812515510000_zuaf173-B52","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1016\/j.jcin.2021.06.003","article-title":"1-Month dual-antiplatelet therapy followed by aspirin monotherapy after polymer-free drug-coated stent implantation: one-month DAPT trial","volume":"14","author":"Hong","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B53","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.4244\/EIJ-D-21-00514","article-title":"Bioabsorbable polymer drug-eluting stents with 4-month dual antiplatelet therapy versus durable polymer drug-eluting stents with 12-month dual antiplatelet therapy in patients with left main coronary artery disease: the IDEAL-LM randomised trial","volume":"17","author":"van Geuns","year":"2022","journal-title":"EuroIntervention"},{"key":"2026042812515510000_zuaf173-B54","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1161\/CIRCULATIONAHA.123.064264","article-title":"Comparison of 3- to 6-month versus 12-month dual antiplatelet therapy after coronary intervention using the contemporary drug-eluting stents with ultrathin struts: the HOST-IDEA randomized clinical trial","volume":"147","author":"Han","year":"2023","journal-title":"Circulation"},{"key":"2026042812515510000_zuaf173-B55","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1056\/NEJMoa2108749","article-title":"Dual antiplatelet therapy after PCI in patients at high bleeding risk","volume":"385","author":"Valgimigli","year":"2021","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B56","doi-asserted-by":"crossref","first-page":"101021","DOI":"10.1016\/j.jacadv.2024.101021","article-title":"Assessment of noninferiority margins in cardiovascular medicine trials","volume":"3","author":"Greco","year":"2024","journal-title":"JACC Adv"},{"key":"2026042812515510000_zuaf173-B57","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1016\/j.jcin.2022.08.009","article-title":"P2y12 inhibitor or aspirin following dual antiplatelet therapy after percutaneous coronary intervention: a network meta-analysis","volume":"15","author":"And\u00f2","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B58","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/jth.13216","article-title":"Effects of P2Y12 receptor inhibition with or without aspirin on hemostatic system activation: a randomized trial in healthy subjects","volume":"14","author":"Traby","year":"2016","journal-title":"J Thromb Haemost"},{"key":"2026042812515510000_zuaf173-B59","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1111\/j.1538-7836.2010.04160.x","article-title":"In the presence of strong P2Y12 receptor blockade, aspirin provides little additional inhibition of platelet aggregation","volume":"9","author":"Armstrong","year":"2011","journal-title":"J Thromb Haemost"},{"key":"2026042812515510000_zuaf173-B60","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.jacc.2019.11.056","article-title":"Ticagrelor with or without aspirin after PCI: the TWILIGHT platelet substudy","volume":"75","author":"Baber","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2026042812515510000_zuaf173-B61","doi-asserted-by":"crossref","first-page":"2414","DOI":"10.1001\/jama.2019.8145","article-title":"Effect of 1-month dual antiplatelet therapy followed by clopidogrel vs 12-month dual antiplatelet therapy on cardiovascular and bleeding events in patients receiving PCI: the STOPDAPT-2 randomized clinical trial","volume":"321","author":"Watanabe","year":"2019","journal-title":"JAMA"},{"key":"2026042812515510000_zuaf173-B62","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1001\/jamacardio.2021.5244","article-title":"Comparison of clopidogrel monotherapy after 1 to 2 months of dual antiplatelet therapy with 12 months of dual antiplatelet therapy in patients with acute coronary syndrome: the STOPDAPT-2 ACS randomized clinical trial","volume":"7","author":"Watanabe","year":"2022","journal-title":"JAMA Cardiol"},{"key":"2026042812515510000_zuaf173-B63","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.1001\/jama.2019.8146","article-title":"Effect of P2Y12 inhibitor monotherapy vs dual antiplatelet therapy on cardiovascular events in patients undergoing percutaneous coronary intervention: the SMART-CHOICE randomized clinical trial","volume":"321","author":"Hahn","year":"2019","journal-title":"JAMA"},{"key":"2026042812515510000_zuaf173-B64","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/S0140-6736(18)31858-0","article-title":"Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-label, randomised superiority trial","volume":"392","author":"Vranckx","year":"2018","journal-title":"Lancet"},{"key":"2026042812515510000_zuaf173-B65","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1056\/NEJMoa1908419","article-title":"Ticagrelor with or without aspirin in high-risk patients after PCI","volume":"381","author":"Mehran","year":"2019","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B66","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1001\/jama.2020.7580","article-title":"Effect of ticagrelor monotherapy vs ticagrelor with aspirin on major bleeding and cardiovascular events in patients with acute coronary syndrome: the TICO randomized clinical trial","volume":"323","author":"Kim","year":"2020","journal-title":"JAMA"},{"key":"2026042812515510000_zuaf173-B67","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1161\/CIRCULATIONAHA.123.066943","article-title":"Stopping aspirin within 1 month after stenting for ticagrelor monotherapy in acute coronary syndrome: the T-PASS randomized noninferiority trial","volume":"149","author":"Hong","year":"2024","journal-title":"Circulation"},{"key":"2026042812515510000_zuaf173-B68","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1016\/S0140-6736(24)00473-2","article-title":"Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): a randomised, placebo-controlled, double-blind clinical trial","volume":"403","author":"Ge","year":"2024","journal-title":"Lancet"},{"key":"2026042812515510000_zuaf173-B69","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1161\/CIRCULATIONAHA.123.066720","article-title":"An aspirin-free versus dual antiplatelet strategy for coronary stenting: STOPDAPT-3 randomized trial","volume":"149","author":"Natsuaki","year":"2024","journal-title":"Circulation"},{"key":"2026042812515510000_zuaf173-B70","doi-asserted-by":"crossref","first-page":"e240877","DOI":"10.1001\/jamanetworkopen.2024.0877","article-title":"P2y12 inhibitor monotherapy vs dual antiplatelet therapy after deployment of a drug-eluting stent: the SHARE randomized clinical trial","volume":"7","author":"Min","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026042812515510000_zuaf173-B71","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1056\/NEJMoa2507980","article-title":"Early withdrawal of aspirin after PCI in acute coronary syndromes","volume":"393","author":"Guimar\u00e3es","year":"2025","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B72","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1056\/NEJMoa2508808","article-title":"Early discontinuation of aspirin after PCI in low-risk acute myocardial infarction","volume":"393","author":"Tarantini","year":"2025","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B73","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1001\/jamacardio.2024.0133","article-title":"Ticagrelor or clopidogrel monotherapy vs dual antiplatelet therapy after percutaneous coronary intervention: a systematic review and patient-level meta-analysis","volume":"9","author":"Valgimigli","year":"2024","journal-title":"JAMA Cardiol"},{"key":"2026042812515510000_zuaf173-B74","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1016\/j.jacc.2019.08.1038","article-title":"Ticagrelor alone versus dual antiplatelet therapy from 1 month after drug-eluting coronary stenting","volume":"74","author":"Franzone","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026042812515510000_zuaf173-B75","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/S0140-6736(24)01616-7","article-title":"De-escalation to ticagrelor monotherapy versus 12 months of dual antiplatelet therapy in patients with and without acute coronary syndromes: a systematic review and individual patient-level meta-analysis of randomised trials","volume":"404","author":"Valgimigli","year":"2024","journal-title":"Lancet"},{"key":"2026042812515510000_zuaf173-B76","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1016\/S0140-6736(16)31323-X","article-title":"Platelet function monitoring to adjust antiplatelet therapy in elderly patients stented for an acute coronary syndrome (ANTARCTIC): an open-label, blinded-endpoint, randomised controlled superiority trial","volume":"388","author":"Cayla","year":"2016","journal-title":"Lancet"},{"key":"2026042812515510000_zuaf173-B77","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1016\/S0140-6736(17)32155-4","article-title":"Guided de-escalation of antiplatelet treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention (TROPICAL-ACS): a randomised, open-label, multicentre trial","volume":"390","author":"Sibbing","year":"2017","journal-title":"Lancet"},{"key":"2026042812515510000_zuaf173-B78","doi-asserted-by":"crossref","first-page":"3070","DOI":"10.1093\/eurheartj\/ehx175","article-title":"Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study","volume":"38","author":"Cuisset","year":"2017","journal-title":"Eur Heart J"},{"key":"2026042812515510000_zuaf173-B79","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1056\/NEJMoa1907096","article-title":"A genotype-guided strategy for oral P2Y 12 inhibitors in primary PCI","volume":"381","author":"Claassens","year":"2019","journal-title":"N Engl J Med"},{"key":"2026042812515510000_zuaf173-B80","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/S0140-6736(21)01445-8","article-title":"Unguided de-escalation from ticagrelor to clopidogrel in stabilised patients with acute myocardial infarction undergoing percutaneous coronary intervention (TALOS-AMI): an investigator-initiated, open-label, multicentre, non-inferiority, randomised trial","volume":"398","author":"Kim","year":"2021","journal-title":"Lancet"},{"key":"2026042812515510000_zuaf173-B81","doi-asserted-by":"crossref","first-page":"339","DOI":"10.2459\/JCM.0000000000001737","article-title":"Dual antiplatelet therapy de-escalation by discontinuation in patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis","volume":"26","author":"Spagnolo","year":"2025","journal-title":"J Cardiovasc Med"},{"key":"2026042812515510000_zuaf173-B82","doi-asserted-by":"crossref","first-page":"009","DOI":"10.1055\/s-0038-1676612","article-title":"The conundrum surrounding racial differences on ischaemic and bleeding risk with dual anti-platelet therapy","volume":"119","author":"Greco","year":"2019","journal-title":"Thromb Haemost"},{"key":"2026042812515510000_zuaf173-B83","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jcin.2021.11.028","article-title":"Short duration of DAPT versus de-escalation after percutaneous coronary intervention for acute coronary syndromes","volume":"15","author":"Laudani","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B84","doi-asserted-by":"crossref","first-page":"e082561","DOI":"10.1136\/bmj-2024-082561","article-title":"P2y12 inhibitor or aspirin after percutaneous coronary intervention: individual patient data meta-analysis of randomised clinical trials","volume":"389","author":"Giacoppo","year":"2025","journal-title":"BMJ"},{"key":"2026042812515510000_zuaf173-B85","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1016\/j.jcin.2025.04.042","article-title":"Antiplatelet monotherapy after short DAPT in ACS","volume":"18","author":"Greco","year":"2025","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B86","doi-asserted-by":"crossref","first-page":"348","DOI":"10.31083\/j.rcm2310348","article-title":"P2y12 inhibitor monotherapy: considerations for acute and long-term secondary prevention post-PCI","volume":"23","author":"Greco","year":"2022","journal-title":"Rev Cardiovasc Med"},{"key":"2026042812515510000_zuaf173-B87","doi-asserted-by":"crossref","first-page":"571","DOI":"10.4244\/EIJ-D-24-00829","article-title":"Prasugrel monotherapy versus standard DAPT in STEMI patients with OCT-guided or angio-guided complete revascularisation: design and rationale of the randomised, multifactorial COMPARE STEMI ONE trial","volume":"21","author":"Paradies","year":"2025","journal-title":"EuroIntervention"},{"key":"2026042812515510000_zuaf173-B88","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1080\/14779072.2021.1902806","article-title":"Differences in coronary artery disease and outcomes of percutaneous coronary intervention with drug-eluting stents in women and men","volume":"19","author":"Greco","year":"2021","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2026042812515510000_zuaf173-B89","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1007\/s40256-024-00670-4","article-title":"Characteristics and impact of randomized trials on drugs or devices in cardiovascular medicine","volume":"24","author":"Spagnolo","year":"2024","journal-title":"Am J Cardiovasc Drugs"},{"key":"2026042812515510000_zuaf173-B90","doi-asserted-by":"crossref","first-page":"e015529","DOI":"10.1161\/CIRCINTERVENTIONS.125.015529","article-title":"Advances in the detection and management of vulnerable coronary plaques","volume":"18","author":"Spagnolo","year":"2025","journal-title":"Circ Cardiovasc Interv"},{"key":"2026042812515510000_zuaf173-B91","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1161\/CIRCULATIONAHA.124.069210","article-title":"Lipoprotein (a) as a pharmacological target: premises, promises and prospects","volume":"151","author":"Greco","year":"2025","journal-title":"Circulation"},{"key":"2026042812515510000_zuaf173-B92","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.jacc.2025.07.064","article-title":"Targeting inflammation in acute myocardial infarction","volume":"86","author":"Imbesi","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"2026042812515510000_zuaf173-B93","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1093\/ehjcvp\/pvaf058","article-title":"Anti-inflammatory pharmacotherapy in patients with cardiovascular disease","volume":"11","author":"Finocchiaro","year":"2025","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"2026042812515510000_zuaf173-B94","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1080\/14779072.2025.2564137","article-title":"Anti-inflammatory strategies for patients with atherosclerotic coronary disease","volume":"23","author":"Imbesi","year":"2025","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2026042812515510000_zuaf173-B95","doi-asserted-by":"crossref","first-page":"ehaf649","DOI":"10.1093\/eurheartj\/ehaf649","article-title":"Tailored DAPT: still a theory in search of proof","author":"Capodanno","year":"2025","journal-title":"Eur Heart J"},{"key":"2026042812515510000_zuaf173-B96","doi-asserted-by":"crossref","first-page":"2352","DOI":"10.1016\/j.jacc.2025.08.040","article-title":"Personalized or standard duration of dual antiplatelet therapy after percutaneous coronary intervention: PARTHENOPE randomized trial","volume":"86","author":"Piccolo","year":"2025","journal-title":"JACC"},{"key":"2026042812515510000_zuaf173-B97","doi-asserted-by":"crossref","first-page":"e05","DOI":"10.15420\/icr.2021.30","article-title":"Antithrombotic management in AF patients following percutaneous coronary intervention: a European perspective","volume":"18","author":"Greco","year":"2023","journal-title":"Interv Cardiol"},{"key":"2026042812515510000_zuaf173-B98","doi-asserted-by":"crossref","first-page":"e017212","DOI":"10.1161\/JAHA.120.017212","article-title":"Safety and efficacy of double antithrombotic therapy with non\u2013vitamin K antagonist oral anticoagulants in patients with atrial fibrillation undergoing percutaneous coronary intervention: a systematic review and meta-analysis","volume":"9","author":"Capodanno","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2026042812515510000_zuaf173-B99","doi-asserted-by":"crossref","first-page":"132660","DOI":"10.1016\/j.ijcard.2024.132660","article-title":"Downstream cangrelor versus upstream ticagrelor in patients with ST-segment elevation myocardial infarction: a propensity score-matched analysis","volume":"418","author":"Greco","year":"2025","journal-title":"Int J Cardiol"},{"key":"2026042812515510000_zuaf173-B100","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/s40256-024-00666-0","article-title":"Sodium-glucose cotransporter-2 inhibitors: elevating standards in cardiovascular secondary prevention","volume":"24","author":"Greco","year":"2024","journal-title":"Am J Cardiovasc Drugs"},{"key":"2026042812515510000_zuaf173-B101","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1080\/14796678.2025.2450189","article-title":"Current and future role of PCSK9 inhibitors in ASCVD prevention","volume":"21","author":"Greco","year":"2025","journal-title":"Future Cardiol"},{"key":"2026042812515510000_zuaf173-B102","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1080\/14779072.2023.2288169","article-title":"PCSK9 inhibitors: current status and emerging frontiers in lipid control","volume":"22","author":"Agnello","year":"2023","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2026042812515510000_zuaf173-B103","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1080\/14656566.2023.2171788","article-title":"Advances in the available pharmacotherapy for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation","volume":"24","author":"Greco","year":"2023","journal-title":"Expert Opin Pharmacother"},{"key":"2026042812515510000_zuaf173-B104","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1080\/17434440.2024.2439028","article-title":"Stent type selection in high bleeding risk patients","volume":"21","author":"Greco","year":"2024","journal-title":"Expert Rev Med Devices"},{"key":"2026042812515510000_zuaf173-B105","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1093\/ehjdh\/ztaf056","article-title":"Clinical feasibility of a quick response code-based digital self-reporting of medication adherence: results in patients on ticagrelor therapy from the APOLLO-QR observational study","volume":"6","author":"Francaviglia","year":"2025","journal-title":"Eur Heart J Digit Health"}],"container-title":["European Heart Journal: Acute Cardiovascular Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjacc\/advance-article-pdf\/doi\/10.1093\/ehjacc\/zuaf173\/66264482\/zuaf173.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjacc\/article-pdf\/15\/4\/318\/66264482\/zuaf173.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjacc\/article-pdf\/15\/4\/318\/66264482\/zuaf173.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:52:17Z","timestamp":1777395137000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjacc\/article\/15\/4\/318\/8414101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":105,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,1,5]]},"published-print":{"date-parts":[[2026,4,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjacc\/zuaf173","relation":{},"ISSN":["2048-8726","2048-8734"],"issn-type":[{"value":"2048-8726","type":"print"},{"value":"2048-8734","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,1,5]]}}}