Abstract Body (Do not enter title and authors here): Introduction
Current guidelines recommend dual antiplatelet therapy (DAPT) for 6 months for stable ischemic heart disease and 12 months for acute coronary syndrome following percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. However, long-term DAPT is associated with increased bleeding risk.

Objective
To compare short DAPT (≤3 months) followed by P2Y12 inhibitor (P2Y12i) monotherapy until 12 months vs. standard DAPT for 12 months in patients undergoing PCI with DES.

Methods
We systematically searched PubMed, Scopus, and Cochrane Central databases for studies comparing short DAPT followed by P2Y12i monotherapy vs. 12-month DAPT following PCI. The co-primary outcomes were composite major adverse cardiovascular/cerebrovascular events (MACCE) and net adverse clinical events (NACE; MACCE + bleeding events) at 12 months post-PCI. Secondary outcomes were major and any bleeding, myocardial infarction (MI), stroke, stent thrombosis, all-cause and cardiovascular mortality, and target vessel revascularization (TVR) at 12 months post-PCI.

Results
The systematic review identified 8 randomized controlled trials including 39,782 patients (short DAPT n=19,877, 49.96%). MACCE (RR 0.88; 95%CI 0.78-0.98; p=0.023; I²=0%) and NACE (RR 0.75; 95%CI 0.65-0.86; p<0.001; I²=56%) at 12 months were significantly lower with short DAPT than 12-month DAPT. Major (RR 0.52; 95%CI 0.37-0.72; p<0.001; I²=63%) and any bleeding (RR 0.55; 95%CI 0.42-0.73; p<0.001; I²=80%) were also significantly lower with short DAPT. MI, stroke, stent thrombosis, all-cause and cardiovascular mortality, and TVR at 12 months did not differ significantly between short and 12-month DAPT.

Conclusion
Short DAPT for ≤3 months followed by P2Y12i monotherapy after PCI with DES was associated with decreased MACCE, NACE, and bleeding without differences in other outcomes. Short DAPT should be considered for high-bleeding risk patients.