Details

Autor(en) / Beteiligte

• Watanabe, Hirotoshi
• Natsuaki, Masahiro
• Morimoto, Takeshi
• Yamamoto, Ko
• Obayashi, Yuki
• Nishikawa, Ryusuke
• Kimura, Tomoya
• Ando, Kenji
• Domei, Takenori
• Suwa, Satoru
• Ogita, Manabu
• Isawa, Tsuyoshi
• Takenaka, Hiroyuki
• Yamamoto, Takashi
• Ishikawa, Tetsuya
• Hisauchi, Itaru
• Wakabayashi, Kohei
• Onishi, Yuko
• Hibi, Kiyoshi
• Kawai, Kazuya
• Yoshida, Ruka
• Suzuki, Hiroshi
• Nakazawa, Gaku
• Kusuyama, Takanori
• Morishima, Itsuro
• Ono, Koh
• Kimura, Takeshi

Titel

Aspirin versus Clopidogrel Monotherapy After Percutaneous Coronary Intervention: 1-Year Follow-up of the STOPDAPT-3 Trial

Ist Teil von

• European heart journal, 2024-08

Ort / Verlag

England

Erscheinungsjahr

2024

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• There was no previous trial comparing aspirin monotherapy with a P2Y12 inhibitor monotherapy following short dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). In the STOPDAPT-3, patients with acute coronary syndrome (ACS) or high bleeding risk (HBR) were randomly assigned to either 1-month DAPT with aspirin and prasugrel followed by aspirin monotherapy (aspirin group) or 1-month prasugrel monotherapy followed by clopidogrel monotherapy (clopidogrel group). This secondary analysis compared aspirin monotherapy with clopidogrel monotherapy by the 30-day landmark analysis. The co-primary endpoints were the cardiovascular endpoint defined as a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, or ischaemic stroke, and the bleeding endpoint defined as Bleeding Academic Research Consortium 3 or 5. Of 6002 assigned patients, 5833 patients (aspirin group: N = 2920 and clopidogrel group: N = 2913) were included in the 30-day landmark analysis. Median age was 73 (interquartile range 64-80) years, women 23.4%, ACS 74.6%, and HBR 54.1%. The assigned monotherapy was continued at 1 year in 87.5% and 87.2% in the aspirin and clopidogrel groups, respectively. The incidence rates beyond 30 days and up to 1 year were similar between the aspirin and clopidogrel groups for both cardiovascular endpoint (4.5 and 4.5 per 100 person-year, hazard ratio [HR] 1.00 [95% confidence interval (CI) 0.77-1.30], P = .97), and bleeding endpoint (2.0 and 1.9, HR 1.02 [95% CI 0.69-1.52], P = .92). Aspirin monotherapy compared to clopidogrel monotherapy was associated with similar cardiovascular and bleeding outcomes beyond 1 month and up to 1 year after PCI with DES.