A new study presented at ESC Congress 2025 suggests that three months of dual antiplatelet therapy (DAPT) may improve survival and reduce bleeding risk compared to 12 months of DAPT in patients recovering from a heart attack (myocardial infarction or MI).
Patients are at the highest risk of recurrent heart events during the first 1–3 months after a heart attack.
While guidelines recommend 12 months of DAPT, recent evidence indicates shorter durations may be equally effective in preventing new heart problems, while reducing the risk of bleeding.
The DUAL-ACS trial was conducted by researchers in Scotland, England, and New Zealand. It included 5,052 patients who had a type 1 heart attack within the previous 12 weeks. Patients were randomly assigned to receive either 3 months or 12 months of DAPT (aspirin and a P2Y12 inhibitor).
The average age of participants was 63, and 27% were women. About 70% had stents placed, 6% had bypass surgery, and 23% were managed with medications only.
After 15 months of follow-up:
All-cause death: 2.7% in the 3-month group vs. 3.4% in the 12-month group.
Cardiovascular death or repeat heart attack: no significant difference.
Major bleeding: 3.2% in the 3-month group vs. 4.0% in the 12-month group.
While the trial enrolled only 30% of the planned number of participants and cannot provide a definitive answer, the findings align with previous studies. They suggest that shorter DAPT (3 months) may be just as effective and safer than the standard 12-month course.
Professor David Newby, the lead investigator, stated: “There was no evidence that 12 months of DAPT gave additional benefit. In fact, the trends suggest that limiting DAPT to 3 months may be safer in real-world patients.”
If you care about heart health, please read studies that Changing blood pressure readings is a hidden sign of heart disease and common type 2 diabetes drugs may raise heart risk.
For more about heart health, please read studies about root cause of heart rhythm disorders and Warning signal from the kidneys can predict future heart failure risk.
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