Noncompliance and cessation of dual antiplatelet therapy after coronary stenting: looking at the speck rather than noticing the log?

A distinctive feature of interventional cardiologists relies in the fact that they take care of patients well before and after the invasive procedures. This explains why the most appropriate medical management following percutaneous coronary intervention (PCI) remains a key issue for interventionalists. History reminds us that the first stents (Wallstent and Palmaz-Schatz) were plagued by an almost unethically high short-term risk of thrombosis. Antonio Colombo’s breakthrough with dual antiplatelet therapy (DAPT) ushered a new era for stenting, shifting the focus from thrombosis to restenosis. Yet, the advent of drug-eluting stents (DES) more than 10 years ago brought again a wave of uncertainty on the safety of PCI, and in 2006 the European Society of Cardiology Congress highlighted the potentially deadly hazard associated with DES (2).