Which patients require dual antiplatelet therapy after STEMI or high-risk NSTEMI treated with PCI, and for how long?

• A. 3 months
• B. Indefinitely
• C. At least 6–12 months, longer depending on stent type and bleeding risk
• D. 6 weeks

Answer: (C)

After PCI with stent placement for STEMI or high‑risk NSTEMI, the stented artery is prone to clotting until the vessel heals and becomes endothelialized. Dual antiplatelet therapy—aspirin plus a P2Y12 inhibitor—protects against stent thrombosis during that healing window and reduces recurrent ischemic events.

The duration is best described as at least 6–12 months. This window provides substantial protection while the stent settles, which is especially important in the high-risk ACS setting. The exact length is tailored to the patient: you may extend beyond 12 months if the patient has a high ischemic risk and a low bleeding risk, or shorten if the bleeding risk is prohibitive. The type of stent also influences duration; newer-generation stents may allow longer or, in higher bleeding risk, shorter durations, but the general principle remains that longer DAPT is often needed in ACS treated with PCI, rather than stopping early or using an indefinite course in most patients.