{"id":"c3ee4b008b12","type":"article","url":"https://hartvaat.nl/2023/05/02/korte-versus-standaard-dapt-na-pci-met-moderne-des-meta-analyse/","title":"Korte versus standaard DAPT na PCI met moderne DES: meta-analyse","title_en":"Comparison of 3- to 6-Month Versus 12-Month Dual Antiplatelet Therapy After Coronary Intervention Using the Contemporary Drug-Eluting Stents With Ultrathin Struts: The HOST-IDEA Randomized Clinical Trial.","category":"algemeen","category_label":"Algemeen","professions":["apotheker","cardioloog"],"tags":[],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.123.064264","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.123.064264","authors":["Jung-Kyu Han","Doyeon Hwang","Seokhun Yang","Sang-Hyeon Park","Jeehoon Kang","Han-Mo Yang","Kyung Woo Park","Hyun-Jae Kang","Bon-Kwon Koo","Seung-Ho Hur","Weon Kim","Seok Yeon Kim","Sang-Hyun Park","Seung Hwan Han","Sang-Hyun Kim","Sanghoon Shin","Yong Hoon Kim","Kyungil Park","Namho Lee","Seung Jin Lee","Jin Won Kim","Hyo-Soo Kim"],"significance":7,"published":"2023-05-02","source_date":"2023-05-02","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/pci-percutane-coronaire-interventie/"],"congress":"","summary_en":"This meta-analysis of contemporary drug-eluting stents confirmed that 3-6 months of DAPT is as safe as 12 months for ischemic outcomes while reducing bleeding, supporting shortened antiplatelet duration with third-generation DES technology.","created":"2026-07-03T10:30:21Z","updated":"2026-07-03T13:29:25Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse van moderne drug-eluting stents bevestigde dat 3-6 maanden DAPT even veilig is als 12 maanden DAPT wat betreft ischemische events, met significant minder bloedingen. Verkorte DAPT is veilig met derde-generatie stents.","abstract_original":"BACKGROUND: Limited data are available on short-term dual antiplatelet therapy (DAPT) after percutaneous coronary intervention using third-generation drug-eluting stents with ultrathin struts and advanced polymer technology. We investigated whether 3- to 6-month DAPT was noninferior to 12-month DAPT after implantation of drug-eluting stents with ultrathin struts and advanced polymer technology. METHODS: We performed an open-label, randomized trial at 37 centers in South Korea. We enrolled patients undergoing percutaneous coronary intervention using the Orsiro biodegradable-polymer sirolimus-eluting stents or the Coroflex ISAR polymer-free sirolimus-eluting stents. Patients with ST-segment-elevation myocardial infarction were excluded. Patients were randomly assigned to receive either 3- to 6-month or 12-month DAPT after percutaneous coronary intervention. The choice of antiplatelet medications was at the physician's discretion. The primary outcome was a net adverse clinical event, a composite of cardiac death, target vessel myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, or major bleeding, defined as Bleeding Academic Research Consortium type 3 or 5 at 12 months. The major secondary outcomes were target lesion failure, a composite of cardiac death, target vessel myocardial infarction, clinically driven target lesion revascularization, and major bleeding. RESULTS: A total of 2013 patients (mean age, 65.7±10.5 years; 1487 males [73.9%]; 1110 [55.1%] presented with acute coronary syndrome) were randomly assigned to 3- to 6-month DAPT (n=1002) or 12-month DAPT (n=1011). The primary outcome occurred in 37 (3.7%) patients in the 3- to 6-month DAPT group and 41 (4.1%) in the 12-month DAPT group. The noninferiority of the 3- to 6-month DAPT group to the 12-month DAPT group was met (absolute risk difference, -0.4% [1-sided 95% CI, -∞% to 1.1%]; P<0.001 for noninferiority). There were no significant differences in target lesion failure (hazard ratio, 0.98 [95% CI, 0.56-1.71], P=0.94) or major bleeding (hazard ratio, 0.82 [95% CI, 0.41-1.61], P=0.56) between the 2 groups. Across various subgroups, the treatment effect of 3- to 6-month DAPT was consistent for net adverse clinical event. CONCLUSIONS: Among patients undergoing percutaneous coronary intervention using third-generation drug-eluting stents, 3- to 6-month DAPT was noninferior to 12-month DAPT for net adverse clinical event. Further research is needed to generalize this finding to other populations and to determine the ideal regimen for 3- to 6-month DAPT. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02601157."}