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In this large, real-world population, XIENCE V demonstrated low event rates at 1 year, with several independent predictors. Early DAPT interruption (≤ 30 days) was the most potent predictor of ST, whereas delayed interruption (>30 days) was not predictive. (XIENCE V Everolimus Eluting Coronary Stent System [EECSS] USA Post-Approval Study; NCT00676520).

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C urrent guidelines recommend dual antiplatelet therapy (DAPT) for at least 6 months (European Securities Committee)1 and 1 year (American College of Cardiology/ American Heart Association/Society for Cardiac Angiography and Interventions) 2 after drug-eluting stents (DES) to prevent stent thrombosis (ST), based on studies suggesting that firstgeneration DES are associated with increased rates of ST with premature DAPT discontinuation.3-6 Compared with bare-metal stents and first-generation DES, cobalt-chromium everolimus-eluting stent (CoCr-EES) has in several reports been associated with the lowest rates of early, late, and very late ST. [7][8][9][10] As prolonged use of DAPT has been associated with a significant risk of major bleeding, 11,12 knowing whether short-term DAPT might be safe in patients treated with EES is Background-Whether premature dual antiplatelet therapy (DAPT) interruption is safe in patients receiving cobalt chromium everolimus-eluting stents remains controversial. We sought to examine the relationship between DAPT discontinuation and stent thrombosis (ST) after cobalt chromium everolimus-eluting stents. Methods and Results-Outcomes from 11 219 patients were pooled from 3 randomized trials and 4 registries with 2-year follow-up period after cobalt chromium everolimus-eluting stent implantation. . Conclusions-In this large pooled experience, permanent DAPT discontinuation before 30 days after cobalt chromium everolimus-eluting stent implantation was strongly associated with ST, whereas DAPT discontinuation beyond 90 days appeared safe.