Current national and international guidelines recommend a 1-year dual antiplatelet therapy with aspirin in combination with clopidogrel (or other thienopyridines) in all patients after coronary stent placement. The benefit-risk ratio of prolonging or shortening dual antiplatelet therapy is unclear, and 3 clinical studies published during the 2014 AHA Annual Meeting addressed this issue. The DAPT study was an international multicenter, randomized, placebo-controlled trial that enrolled 9,961 subjects, all of whom were post-coronary stenting and had completed a 12-month period of dual antiplatelet therapy. They were randomized into two groups. Patients in the placebo group received aspirin in combination with placebo, and patients in the thienopyridine group received aspirin in combination with clopidogrel or prasugrel for at least 18 months. The primary effectiveness endpoint was stent thrombosis with major cardiovascular events (myocardial infarction, death, stroke), and the safety endpoint was serious bleeding events. The results showed that patients in the thienopyridine group had significantly fewer major cardiovascular and cerebrovascular events (4,3% versus 5,9%, p < 0,001) and a significantly lower incidence of stent thrombosis (0,4% versus 1,4%, p < 0,001) compared with the placebo group, but patients in the thienopyridine group had an increased incidence of major bleeding events (2,53% versus 1,57%, p = 0,001). This study concludes that prolonged duration of dual antiplatelet therapy in patients after coronary pharmacologic stent placement helps to reduce the risk of major adverse cardiovascular and cerebrovascular events versus stent thrombotic events. The ISAR-SAFE study was a randomized, double-blind, multicenter trial design designed to compare the efficacy of dual antiplatelet therapy in patients after coronary artery drug stent placement, receiving either 6 or 12 months of dual antiplatelet therapy. A total of 4005 patients who had coronary pharmacologic stents placed and completed 6 months of dual antiplatelet therapy with aspirin combined with clopidogrel were enrolled (6000 were originally planned to be enrolled, but the study was terminated early because of the low rate of endpoint events). Subjects were randomized into two groups receiving aspirin and placebo or aspirin and clopidogrel. The primary endpoint was a composite endpoint consisting of death, myocardial infarction, stent thrombosis, stroke, and severe bleeding. The results showed that the primary endpoints of events (1,5% versus 1,6%, p=0,70), death (0,4% versus 0,6%, p=0,37), myocardial infarction (0,7% versus 0,7%, p=0,85), stent thrombosis (0,3% versus 0,2%, p=0,74), stroke (0,4% versus 0,3%, p=0,57), and severe bleeding were the same as for the patients in the group that received either 6 or 12 months of dual antiplatelet therapy. percent, p=0,57), stroke (0,4 percent versus 0,3 percent, p=0,74), and severe bleeding (0,2 percent versus 0,3 percent, p=0,74) were not significantly different. This study concluded that patients receiving 6 months of dual antiplatelet therapy after coronary pharmacologic stenting were not inferior to the 12-month course group. The ITALIC study, published almost simultaneously, showed no significant difference in the incidence of endpoint events (death, myocardial infarction, target vessel revascularization, stroke with major bleeding events) in patients implanted with everolimus medicated stents after 6 or 24 months of dual antiplatelet therapy (1,5% versus 1,6%, p=0,85). The results of these 3 studies may seem contradictory, but a careful review of the evidence suggests the following: 1. For prevention of stent thrombotic events, 6 months of dual antiplatelet therapy is sufficient to achieve satisfactory efficacy (especially with newer pharmacologic stents). 2. Extending the duration of dual antiplatelet therapy can further reduce the risk of thrombotic events in coronary arteries other than stented vessels. 3, DAPT study showed that prolonged dual antiplatelet therapy can increase the risk of bleeding events, but the incidence of fatal bleeding events is very low. When compared with the benefits of stent thrombosis and the decreased risk of myocardial infarction, the benefits clearly outweigh the disadvantages. That is, prolonged dual antiplatelet duration has a favorable benefit-risk ratio. 4. In clinical practice, it is not advisable to set a specific course of dual antiplatelet therapy for all patients, and individualized treatment regimens should be developed based on patient-specific conditions. For example, for patients with a history of bleeding or other high risk factors for bleeding, the duration of dual antiplatelet therapy can be shortened appropriately, while patients with a higher risk of thrombotic events (e.g., multiple ischemic risk factors or multibranch lesions) should have a prolonged course of therapy, and some patients may require longer treatment.