1) The study investigated the effects of prolonged dual antiplatelet therapy (DAPT) beyond 12 months after drug-eluting stent implantation for coronary bifurcation lesions. 2) Among 2082 patients event-free at 12 months post-procedure, those receiving DAPT for ≥12 months (n=1776) had lower rates of all-cause death, myocardial infarction, and stent thrombosis at 4 years compared to those on DAPT <12 months (n=306). 3) Prolonged DAPT ≥12 months was associated with reduced long-term risks for bifurcation lesions, including left main lesions, compared to shorter DAPT.