What is the duration for dual antiplatelet therapy with clopidogrel after placement of a drug-eluting stent?

The recommended duration for dual antiplatelet therapy (DAPT) with clopidogrel following the placement of a drug-eluting stent (DES) is typically 1 year. This guideline is based on extensive clinical evidence demonstrating that prolonged DAPT significantly reduces the risk of thrombotic events, such as stent thrombosis and myocardial infarction, which can occur if the antiplatelet therapy is prematurely discontinued.

Stents that release medication to prevent restenosis - known as drug-eluting stents - require longer periods of DAPT compared to bare-metal stents to allow adequate endothelialization and to mitigate the risk of thrombosis. The guideline of 1 year of DAPT has become the standard following various studies, which show that stopping treatment early increases the risk of major cardiovascular events.

However, the decision for the duration of therapy may be modified based on individual patient risk factors and clinical scenarios, but the 1-year recommendation is what the current guidelines advocate for most patients receiving a DES. This duration strikes a balance between minimizing ischemic risks while also mitigating the heightened risk of bleeding complications that can arise with extended antiplatelet therapy.