What is best to add to aspirin for a post-PCI patient with a drug-eluting stent?

In the context of managing a patient who has undergone percutaneous coronary intervention (PCI) with a drug-eluting stent, the optimal antiplatelet regimen is critical to prevent thrombotic events. The standard approach involves dual antiplatelet therapy, where aspirin is combined with a P2Y12 inhibitor.

Utilizing clopidogrel 75 mg daily for 6 months is supported by clinical guidelines recommending a duration of dual antiplatelet therapy (DAPT) that typically ranges from 6 to 12 months after placement of drug-eluting stents to minimize the risk of stent thrombosis while balancing the risk of bleeding. This duration has shown efficacy in preventing adverse cardiovascular events without significantly increasing the risk of major bleeding when compared to longer periods of therapy.

In contrast, the other options either suggest a shorter duration of therapy, which may not provide adequate protection against stent-related complications, especially given the patient’s increased risk of thrombosis during the early period following stent placement. Additionally, while ticagrelor is a potent alternative with some advantages over clopidogrel, the choices of duration and dosing in other options do not conform to the evidence-based recommendations for optimal DAPT regimens following drug-eluting st