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New ACC/AHA Guidelines Will Curb DAPT Duration for Some

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EXPERT ANALYSIS FROM THE CARDIOVASCULAR CONFERENCE AT SNOWMASS

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The DAPT trial investigators have developed a risk score in an effort to aid clinicians in deciding whether to extend DAPT for more than 12 months after stent placement for ACS in a given individual. The score, which utilizes eight clinical variables, was unveiled at last November’s AHA scientific sessions. For patients with a DAPT score of 2 or more, the number needed to treat for 18 additional months after the initial 12 months of DAPT in order to prevent one major adverse cardiovascular event was 34, with the number needed to harm in the form of major bleeding being 272. For patients with a DAPT score of less than 2, the number needed to treat was 153, and the number needed to harm was 64.

However, Dr. O’Gara said he doesn’t consider the DAPT score ready for use in daily clinical practice for a couple of reasons: It hasn’t yet been validated externally, and it hasn’t yet been published in a peer-reviewed journal.

“I suspect it’s going through a lot of editorial revisions in terms of its statistical underpinnings,” the cardiologist said.

He reported having no financial conflicts of interest regarding his presentation.

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