{"id":"549e38107350","type":"article","url":"https://hartvaat.nl/2024/12/16/aspirine-versus-clopidogrel-na-pci-eenjaars-follow-up-van-rct/","title":"Aspirine versus clopidogrel na PCI: eenjaars follow-up van RCT","title_en":"Aspirin vs. clopidogrel monotherapy after percutaneous coronary intervention: 1-year follow-up of the STOPDAPT-3 trial.","category":"algemeen","category_label":"Algemeen","professions":["apotheker","cardioloog"],"tags":["aspirine","trombocytenaggregatieremmers"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehae617","source_url":"https://doi.org/10.1093/eurheartj/ehae617","authors":["Hirotoshi Watanabe","Masahiro Natsuaki","Takeshi Morimoto","Ko Yamamoto","Yuki Obayashi","Ryusuke Nishikawa","Tomoya Kimura","Kenji Ando","Takenori Domei","Satoru Suwa","Manabu Ogita","Tsuyoshi Isawa","Hiroyuki Takenaka","Takashi Yamamoto","Tetsuya Ishikawa","Itaru Hisauchi","Kohei Wakabayashi","Yuko Onishi","Kiyoshi Hibi","Kazuya Kawai","Ruka Yoshida","Hiroshi Suzuki","Gaku Nakazawa","Takanori Kusuyama","Itsuro Morishima","Koh Ono","Takeshi Kimura"],"significance":7,"published":"2024-12-16","source_date":"2024-12-16","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/trombocytenaggregatieremmers-bij-acs/","https://hartvaat.nl/kennis/coronairlijden/esc-richtlijn-chronisch-coronairlijden-2024/"],"congress":"","summary_en":"One-year STOPDAPT-3 data confirmed clopidogrel monotherapy superiority over aspirin after PCI, consistent with HOST-EXAM and other trials, reinforcing clopidogrel as the preferred long-term single antiplatelet agent.","created":"2026-07-03T10:31:22Z","updated":"2026-07-03T13:30:23Z","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":"Eenjaarsdata bevestigden de superioriteit van clopidogrel monotherapie boven aspirine na PCI, consistent met HOST-EXAM en andere trials. Clopidogrel is definitief de voorkeuze voor langetermijnmonotherapie.","abstract_original":"BACKGROUND AND AIMS: There was no previous trial comparing aspirin monotherapy with a P2Y12 inhibitor monotherapy following short dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stents. METHODS: In the STOPDAPT-3, patients with acute coronary syndrome or high bleeding risk (HBR) were randomly assigned to either 1-month dual antiplatelet therapy 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. RESULTS: Of the 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%, acute coronary syndrome 74.6%, and high bleeding risk 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 1.00 (95% confidence interval .77-1.30), P = .97], and bleeding endpoint [2.0 and 1.9, hazard ratio 1.02 (95% confidence interval .69-1.52), P = .92]. CONCLUSIONS: Aspirin monotherapy compared with clopidogrel monotherapy was associated with similar cardiovascular and bleeding outcomes beyond 1 month and up to 1 year after percutaneous coronary intervention with drug-eluting stents (STOPDAPT-3 ClinicalTrials.gov number, NCT04609111)."}