Impact of six versus 12 months of dual antiplatelet therapy in patients with drug‐eluting stent implantation after risk stratification with the residual SYNTAX score: Results from a secondary analysis of the I‐LOVE‐IT 2 trial

Background The optimal duration of dual antiplatelet therapy (DAPT) after drug‐eluting stent (DES) implantation remains undetermined, especially for those at high risk of cardiac events postprocedure. Objectives This study was aimed to investigate the impact of 6 versus 12 months of DAPT after DES implantation based on risk stratification with the residual SYNTAX score (rSS). Methods A total of 2737 patients in the I‐LOVE‐IT 2 trial were grouped according to rSS status (low rSS [rSS = 0, n = 1474] versus high rSS [rSS > 0, n = 1263]) and DAPT duration (6 months vs. 12 months). The primary endpoint was 12‐month target lesion failure (TLF), and the major secondary endpoints were 12‐month net adverse clinical events (NACE) and major bleeding. Results Incidences of TLF (5.2 vs. 7.4%, P = 0.01) and NACE (9.2 vs. 13.4%, P