Monotherapy with Aspirin vs. Clopidogrel After Coronary Stenting

A large Korean study suggests that clopidogrel alone is preferred after the initial period of dual antiplatelet therapy.

Dual antiplatelet therapy (DAPT) with aspirin plus a platelet P2Y₁₂ receptor antagonist reduces ischemic complications (including stent thrombosis) in the first 6 to 12 months after percutaneous coronary intervention (PCI) with stent placement. Current guidelines recommend switching to single antiplatelet therapy after this early period to prevent secondary coronary events. Although low-dose aspirin is generally prescribed for this purpose, a P2Y₁₂ inhibitor might be preferred, given its greater antiplatelet effect and lack of direct gastrointestinal toxicity. The industry-supported HOST-EXAM study addressed this issue (NCT02044250).

Investigators randomized 5530 Korean patients (mean age, 63; women, 25%), who had undergone coronary stenting…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)