skip to main content

DAPT Duration Post-ACS DES — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyCardiologyDAPT Duration Post-ACS DESRACP Adult Medicine

A 50-year-old man 1 year post-STEMI on DAPT (aspirin + ticagrelor), atorvastatin 80 mg, and ramipril asks about stopping ticagrelor. He had a DES to the LAD. No recurrent events. LDL-C is 1.5 mmol/L. LVEF 45%. What is the recommended DAPT duration after DES for ACS?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — 12 months then aspirin alone (standard)

Standard DAPT duration after ACS with DES: 12 months (aspirin + P2Y12 inhibitor — ticagrelor or prasugrel preferred over clopidogrel for ACS). After 12 months: de-escalate to aspirin monotherapy (standard) OR consider extended DAPT (>12 months) if high ischaemic risk and low bleeding risk (PEGASUS-TIMI 54: ticagrelor 60 mg BD + aspirin reduced MACE). Alternatively: switch to P2Y12 monotherapy (TWILIGHT, TICO trials: ticagrelor monotherapy after 3 months reduced bleeding without increasing ischaemia).

Reference: CSANZ – 2025 – ACS; ESC 2024; PEGASUS/TWILIGHT Trials