Season 3 - Ep.28: DAPT: how short is too short? - Obesity and atrial fibrillation

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Dec 4, 2025

Steffen Massberg, a cardiology expert, discusses the nuances of dual antiplatelet therapy duration and strategies tailored for high bleeding-risk patients. He emphasizes the safety of shorter DAPT in complex cases. Joining him is Prash Sanders, a cardiac electrophysiologist, who delves into the obesity-related mechanisms that contribute to atrial fibrillation, highlighting the significance of weight loss thresholds for reducing AF risk. Both guests stress the importance of proactive risk management in improving heart health outcomes.

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ADVICE

Tailor DAPT Using ARC-HBR Risk Scores

Use risk scores like ARC-HBR to identify high bleeding risk patients after PCI.
Shorten DAPT when HBR is present, tailoring duration to individual bleeding and ischemic risk factors.

ADVICE

Minimise Triple Therapy Duration

For patients on oral anticoagulation after PCI, limit triple therapy to about one week when possible.
Consider extending to one month only for very high ischemic-risk situations like complex lesions or suboptimal PCI.

INSIGHT

Better Stents Lower Ischemic Risk

Modern stent platforms and better PCI techniques have reduced ischemic risk after PCI.
These advances support safely shortening DAPT in many patients when PCI is optimised and guided by intravascular imaging.

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This episode covers:

Cardiology This Week: A concise summary of recent studies
DAPT: how short is too short
Obesity and atrial fibrillation
Milestones: COURAGE

Host: Emer Joyce

Guests: Carlos Aguiar, Steffen Massberg, Prash Sanders

Want to watch that episode? Go to: https://esc365.escardio.org/event/2178

Want to watch that extended interview on dual antiplatelet therapy (DAPT) and shortening its optimal duration, go to: https://esc365.escardio.org/event/2178?resource=interview

Disclaimer

ESC TV Today is supported by Bristol Myers Squibb and Novartis through an independent funding.

The programme has not been influenced in any way by its funding partners.

This programme is intended for health care professionals only and is to be used for educational purposes.

The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices.

Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC.

The ESC is not liable for any translated content of this video.

The English language always prevails.

Declarations of interests

Stephan Achenbach, Yasmina Bououdina, Emer Joyce, Nicolle Kraenkel and Steffen Massberg have declared to have no potential conflicts of interest to report.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI.

Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo.

Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Prashanthan Sanders has declared to have potential conflicts of interest to report: advisory board representative University of Adelaide, Medtronic, Boston Scientific, CathRx, Abbott and Pacemate as well as research grants for University of Adelaide: Medtronic, Abbott, Boston Scientific, Becton Dickson.

Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.