A new study published in PLoS One explored the prevalence and predictors of dual antiplatelet therapy DAPT prolongation beyond one year after acute coronary syndrome ACS in a prospective observational multicenter Italian registry. This study identified 596 patients who were on DAPT and had completed 12 month follow up. The findings revealed that a decision to prolong DAPT beyond one year was taken in 79 patients whereas in 517 patients DAPT was stopped. The strongest predictors of DAPT continuation were a new cardiovascular event after the index admission event no bleeding complications and no anemia during one year follow up. Other independent predictors were renal failure and peripheral artery disease. The choice of DAPT prolongation was not correlated with younger age presence of diabetes mellitus coronary angioplasty as initial treatment strategy or the type of implanted stent drug eluting versus bare metal . Therefore this study rendered a practical insight on the factors influencing the option to continue DAPT beyond one year after ACS. It was stated that a low bleeding risk seems to influence the choice to prolong DAPT more than a high ischemic risk.