DAPT Strategies in ACS
A 75-year-old woman with diabetes mellitus, chronic obstructive pulmonary disease, end-stage renal disease on hemodialysis, and hypertension is admitted to the hospital with chest pain and shortness of breath. Her pulse is 82 beats/min, blood pressure is 141/53 mmHg, and oxygen saturation is 96% on room air. An electrocardiogram demonstrates normal sinus rhythm with non-specific T-wave abnormality. Troponin T is elevated (0.656 ng/mL; reference range 0.000-0.029 ng/mL). She is diagnosed with non-ST-segment elevation myocardial infarction and treated with aspirin, clopidogrel, and unfractionated heparin. An echocardiogram demonstrates left ventricular ejection fraction of 62% with mild mitral regurgitation. She undergoes coronary angiography (Figure 1) that reveals severely calcified 90% stenosis of the left main trunk, 95% stenosis of the ostial left circumflex, and 70% stenosis of the proximal left anterior descending coronary arteries. The patient is treated with complex coronary intervention including rotational atherectomy and Culotte bifurcation stenting of the left main trunk bifurcation. The patient tolerates the procedure well and is planned for discharge.
Which of the following statements regarding dual antiplatelet therapy (DAPT) in this patient is correct?