Treatment Algorithm for Duration of P2Y12 Inhibitor Therapy in Patients With Stable Ischemic Heart Disease
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Patients with a history of ACS > 1 year prior who have since
remained free of recurrent ACS are considered to have transitioned to SIHD. Arrows at the bottom of the figure denote that
the optimal duration of prolonged DAPT is not established. Clopidogrel is the only currently used P2Y12 inhibitor studied in
patients with SIHD undergoing PCI. Aspirin therapy is almost always continued indefinitely in patients with coronary
artery disease.
*High bleeding risk denotes those who have or develop a high risk of bleeding (e.g., treatment with oral anticoagulant
therapy) or are at increased risk of severe bleeding complication (e.g., major intracranial surgery).
ACS indicates acute coronary syndrome; BMS, bare metal stent; CABG, coronary artery bypass graft surgery; DAPT,
dual antiplatelet therapy; DES, drug-eluting stent; Hx, history; MI, myocardial infarction; PCI, percutaneous coronary
intervention; SIHD, stable ischemic heart disease; and S/P, status post.
According to 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet
Therapy in Patients With Coronary Artery Disease
