Ribera A, et al. - Via an observational study based on region-wide registry data linked to pharmacy billing data for dual antiplatelet therapy (DAPT) follow-up of 10,711 subjects with ST-elevation acute coronary syndrome who underwent percutaneous coronary intervention (PCI), the researchers explained the impact of guideline implementation on the trend in 12-month persistence with DAPT between 2010 and 2015 and assessed its correlation with DAPT span regimens suggested at discharge from PCI hospitals. The proportion of subjects on-DAPT at 12 months grew from 58% (56–60) to 73% (71–75) in 2010 and in 2015. Significant growth in the rate of 12-month persistence with DAPT following the publication of clinical guidelines with a time lag of 1 year was noted. A higher risk profile, more widespread and complex coronary disease, use of drug-eluting stents and a 12-month DAPT regimen recommendation at discharge from the PCI hospital were correlated with 12-month persistence. Hence, since the publication of clinical guidelines, persistence with 12-month DAPT had progressed. Only 73% with potential indication were on-DAPT 12 months following PCI, although most subjects were discharged on DAPT. A guideline-based recommendation at PCI hospital discharge was extremely correlated with full persistence with DAPT. Moreover, building evidence-based, common prescribing criteria across hospitals in the acute myocardial infarction-network would promote adherence and decrease variability.