**Dual antiplatelet therapy is only indicated in ACS patients after a stent has been placed. If a patient has an ACS and a heart catheterization is done but no stent is placed, that patient doesn’t require dual antiplatelet therapy (DATP). Patients with ACS but not stent placement only require aspirin therapy. Some
ACC/AHA Guideline on Duration of Dual Antiplatelet Therapy in CAD Patients.
ACC/AHA Guideline on Duration of Dual Antiplatelet Therapy in CAD Patients.
“Dual antiplatelet therapy should extend beyond 1 year for patients with acute coronary syndrome who are not considered at high risk of bleeding, especially those with risk factors associated with high ischemic risk such as diabetes mellitus, peripheral artery disease, left main stenting, or a history of a cardiovascular event. For dual antiplatelet therapy that continues beyond a year, either ticagrelor, 60 mg twice daily, or clopidogrel, 75 mg daily, is recommended in addition to aspirin. The patient’s bleeding and ischemic risk should be reevaluated at least annually.
Dual antiplatelet therapy should continue for at least 1 year in patients who are considered at high risk of bleeding. For patients who are at very high risk of bleeding or who experience significant bleeding while on dual antiplatelet therapy, a duration of less than 1 year is recommended.” ABFM 2017 Critique
Further Reading / References
Circulation. 2016;133:2094-2098. Individualizing Duration of Dual Antiplatelet Therapy After Acute Coronary Syndrome or Percutaneous Coronary Intervention. http://circ.ahajournals.org/content/133/21/2094/tab-article-info