Research Indicates Shorter Blood Thinner Duration Post-Myocardial Infarction May Be as Effective as Longer Treatment
New research from the ESC Congress 2025 suggests that a three-month course of dual antiplatelet therapy may be as effective as traditional longer treatment for myocardial infarction patients, with potential safety benefits.
Recent findings from the DUAL-ACS trial suggest that a three-month course of dual antiplatelet therapy (DAPT) could be as beneficial as the conventional 12-month regimen for patients recovering from a myocardial infarction (MI). Presented at the ESC Congress 2025, this real-world study observed that shorter DAPT duration was associated with a trend toward improved survival and reduced bleeding complications.
The study included over 5,000 patients with recent MI, with an average age of 63 years and a balanced gender distribution. Participants received either three or 12 months of DAPT, combining aspirin and a P2Y12 inhibitor, managed according to standard clinical practices. Follow-up data over approximately 15 months revealed that the three-month group experienced a lower, though not statistically significant, all-cause mortality rate (2.7%) compared to the 12-month group (3.4%). Additionally, major bleeding episodes were slightly lower in the shorter DAPT group (3.2% vs. 4.0%).
Lead researcher Professor David Newby explained that the early phase after a heart attack carries the greatest risk of recurrent events, which often justifies extended DAPT. However, the data suggests that a shorter, three-month course does not compromise patient safety and might reduce bleeding risks associated with prolonged therapy. The trial faced recruitment challenges, especially during the COVID-19 pandemic, but still provides valuable insights into optimized treatment durations for MI patients.
While the evidence is encouraging, the researchers emphasized that the trial was underpowered to definitively answer whether shorter DAPT offers superior benefits. Nonetheless, these findings support reconsidering current guidelines to potentially adopt shorter DAPT regimens, aligning with previous meta-analyses indicating similar efficacy with a more favorable safety profile.
This research highlights the importance of personalized treatment durations and opens avenues for improving long-term outcomes for heart attack patients through tailored therapy plans.
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