Journal of the American College of Cardiology
ACC/AHA Focused Update
2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery DiseaseA Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
Glenn N. Levine, Eric R. Bates, John A. Bittl, Ralph G. Brindis, Stephan D. Fihn, Lee A. Fleisher, Christopher B. Granger, Richard A. Lange, Michael J. Mack, Laura Mauri, Roxana Mehran, Debabrata Mukherjee, L. Kristin Newby, Patrick T. O’Gara, Marc S. Sabatine, Peter K. Smith and Sidney C. Smith Jr.
Table 4
Table 4
Clinical and Procedural Factors Associated With Increased Ischemic Risk (Including Stent Thrombosis) or Increased Bleeding Risk (62–70)
| Increased Ischemic Risk/Risk of Stent Thrombosis (may favor longer-duration DAPT) | Increased Bleeding Risk (may favor shorter-duration DAPT) |
|---|---|
| Increased ischemic risk | History of prior bleeding |
| Advanced age | Oral anticoagulant therapy |
| ACS presentation | Female sex |
| Multiple prior MIs | Advanced age |
| Extensive CAD | Low body weight |
| Diabetes mellitus | CKD |
| CKD | Diabetes mellitus |
| Increased risk of stent thrombosis | Anemia |
| ACS presentation | Chronic steroid or NSAID therapy |
| Diabetes mellitus | |
| Left ventricular ejection fraction <40% | |
| First-generation drug-eluting stent | |
| Stent undersizing | |
| Stent underdeployment | |
| Small stent diameter | |
| Greater stent length | |
| Bifurcation stents | |
| In-stent restenosis |
ACS indicates acute coronary syndrome; CAD, coronary artery disease; CKD, chronic kidney disease; DAPT, dual antiplatelet therapy; MI, myocardial infarction; and NSAID, nonsteroidal anti-inflammatory drug.
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