One or 3 months dual antiplatelet therapy in high bleeding risk patients: splitting hair or aiming at the bullseye?

This commentary discusses the optimal duration of dual antiplatelet therapy (DAPT) in patients with high bleeding risk (HBR) after percutaneous coronary intervention (PCI). The European acute coronary syndrome (ACS) guidelines recommend 1 month of DAPT exclusively for HBR patients, while a recommendation of 3 months of DAPT followed by P2Y12i monotherapy is given for both HBR and non-HBR patients. A network meta-analysis comparing 1 and 3 months of DAPT found no significant difference in major adverse cardiovascular events or bleeding. However, the results should be interpreted with caution due to the limitations of indirect comparison across studies. The authors suggest that both 1- and 3-month DAPT durations are preferable to the default 12-month DAPT in HBR patients. [Extracted from the article]