{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:11:01Z","timestamp":1792725061071,"version":"4.5.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,1,17]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Recent guidelines on dual antiplatelet therapy (DAPT) duration after percutaneous coronary intervention (PCI) balance the subsequent risks of major bleeding with ischemic events. Although generally favoring shorter DAPT duration with second\u2010generation drug\u2010eluting stents, the effects on long\u2010term outcomes in the wider population are uncertain.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We tracked all patients having PCI with second\u2010generation drug\u2010eluting stents in the Veterans Affairs Healthcare System between 2006 and 2016 for death, myocardial infarction, stroke, and major bleeding up to 13\u2009years. We compared these outcomes with 4 DAPT durations of 1 to 5, 6 to 9, 10 to 12, and 13 to 18\u2009months after the index PCI using hazard ratios (HRs) and 95% CIs from Cox proportional hazards models adjusted by inverse probability weighting. A total of 40\u2009882 subjects with PCI were followed up for a median of 4.3 (25%\u201375%: 2.4\u20136.5) years. DAPT discontinuation was rare early after PCI (5.8% at 1\u20135\u2009months and 6.3% at 6\u20139\u2009months) but increased (19% and 44%) &gt;9\u2009months. The risk of cardiovascular and noncardiovascular death was higher (HR, 2.03\u20133.41) with DAPT discontinuation &lt;9\u2009months, likely reflecting premature cessation from factors related to early death. DAPT discontinuation after 9\u2009months following PCI was associated with lower risks of death (HR, 0.93 [95% CI, 0.88\u20130.99]), cardiac death (HR, 0.79 [95% CI, 0.70\u20130.90]), myocardial infarction (HR, 0.75 [95% CI, 0.69\u20130.82]), and major bleeding (HR, 0.82 [95% CI, 0.74\u20130.91]). Results were similar with an index PCI for an acute coronary syndrome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Stopping DAPT after 9\u2009months is associated with lower long\u2010term risks of adverse ischemic and bleeding events and supports recent guidelines of shorter duration DAPT after PCI with second\u2010generation drug\u2010eluting stents.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.027055","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T11:17:31Z","timestamp":1673867851000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Long\u2010Term Outcomes and Duration of Dual Antiplatelet Therapy After Coronary Intervention With Second\u2010Generation Drug\u2010Eluting Stents: The Veterans Affairs Extended DAPT 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MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7144-3146","authenticated-orcid":false,"given":"Rebecca","family":"Sherrod","sequence":"additional","affiliation":[{"name":"Veterans Affairs Boston Healthcare System West Roxbury MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6367-3179","authenticated-orcid":false,"given":"David R.","family":"Gagnon","sequence":"additional","affiliation":[{"name":"Veterans Affairs Boston Healthcare System West Roxbury MA"},{"name":"Department of Biostatistics, Massachusetts Veterans Epidemiology Research &amp; Information Center (MAVERIC) VA Boston Healthcare System Boston MA"},{"name":"Boston University School of Public Health Boston 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