Clopidogrel versus Aspirin Monotherapy Beyond 1 Year After PCI: STOPDAPT-2 5-Year Results.
P2Y(12) inhibition
antiplatelet therapy
bleeding
coronary stent
percutaneous coronary intervention
Journal
Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365
Informations de publication
Date de publication:
18 Oct 2023
18 Oct 2023
Historique:
received:
07
10
2023
accepted:
13
10
2023
medline:
26
10
2023
pubmed:
26
10
2023
entrez:
25
10
2023
Statut:
aheadofprint
Résumé
It remains unclear whether clopidogrel is better suited than aspirin as the long-term antiplatelet monotherapy following dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). We compared clopidogrel monotherapy following 1-month DAPT (clopidogrel group) with aspirin monotherapy following 12-month DAPT (aspirin group) after PCI for 5 years. STOPDAPT-2 is a multicenter, open-label, adjudicator-blinded, randomized clinical trial conducted in Japan. Patients who underwent PCI with cobalt-chromium everolimus-eluting stents were randomized in a 1-to-1 fashion either to clopidogrel or aspirin groups. The primary endpoint was a composite of cardiovascular outcomes (cardiovascular death, myocardial infarction, stroke, or definite stent thrombosis) or major bleeding (TIMI major or minor bleeding). Among 3005 study patients (Age: 68.6±10.7 years; Women: 22.3%; Acute coronary syndrome: 38.3%), 2934 patients (97.6%) completed 5-year follow-up (adherence to the study drugs at 395 days: 84.7% and 75.9%). Clopidogrel group compared with aspirin group was noninferior, but not superior for the primary endpoint (11.75% and 13.57%; HR 0.85 [95%CI: 0.70-1.05], P Clopidogrel might be an attractive alternative to aspirin with a borderline ischemic benefit beyond 1-year after PCI.
Sections du résumé
BACKGROUND
BACKGROUND
It remains unclear whether clopidogrel is better suited than aspirin as the long-term antiplatelet monotherapy following dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI).
OBJECTIVES
OBJECTIVE
We compared clopidogrel monotherapy following 1-month DAPT (clopidogrel group) with aspirin monotherapy following 12-month DAPT (aspirin group) after PCI for 5 years.
METHODS
METHODS
STOPDAPT-2 is a multicenter, open-label, adjudicator-blinded, randomized clinical trial conducted in Japan. Patients who underwent PCI with cobalt-chromium everolimus-eluting stents were randomized in a 1-to-1 fashion either to clopidogrel or aspirin groups. The primary endpoint was a composite of cardiovascular outcomes (cardiovascular death, myocardial infarction, stroke, or definite stent thrombosis) or major bleeding (TIMI major or minor bleeding).
RESULTS
RESULTS
Among 3005 study patients (Age: 68.6±10.7 years; Women: 22.3%; Acute coronary syndrome: 38.3%), 2934 patients (97.6%) completed 5-year follow-up (adherence to the study drugs at 395 days: 84.7% and 75.9%). Clopidogrel group compared with aspirin group was noninferior, but not superior for the primary endpoint (11.75% and 13.57%; HR 0.85 [95%CI: 0.70-1.05], P
CONCLUSIONS
CONCLUSIONS
Clopidogrel might be an attractive alternative to aspirin with a borderline ischemic benefit beyond 1-year after PCI.
Identifiants
pubmed: 37879491
pii: S0735-1097(23)07750-1
doi: 10.1016/j.jacc.2023.10.013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023. Published by Elsevier Inc.