Detailed Information

Cited 0 time in webofscience Cited 0 time in scopus
Metadata Downloads

Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial

Authors
Koo, Bon-KwonKang, JeehoonPark, Kyung WooRhee, Tae-MinYang, Han-MoWon, Ki-BumRha, Seung-WoonBae, Jang-WhanLee, Nam HoHur, Seung-HoYoon, JunghanPark, Tae-HoKim, Bum SooLim, Sang WookCho, Yoon HaengJeon, Dong WoonKim, Sang-HyunHan, Jung-KyuShin, Eun-SeokKim, Hyo-Soo
Issue Date
26-6월-2021
Publisher
ELSEVIER SCIENCE INC
Citation
LANCET, v.397, no.10293, pp.2487 - 2496
Indexed
SCIE
SCOPUS
Journal Title
LANCET
Volume
397
Number
10293
Start Page
2487
End Page
2496
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/137287
DOI
10.1016/S0140-6736(21)01063-1
ISSN
0140-6736
Abstract
Background Optimal antiplatelet monotherapy during the chronic maintenance period in patients who undergo coronary stenting is unknown. We aimed to compare head to head the efficacy and safety of aspirin and clopidogrel monotherapy in this population. Methods We did an investigator-initiated, prospective, randomised, open-label, multicentre trial at 37 study sites in South Korea. We enrolled patients aged at least 20 years who maintained dual antiplatelet therapy without clinical events for 6-18 months after percutaneous coronary intervention with drug-eluting stents (DES). We excluded patients with any ischaemic and major bleeding complications. Patients were randomly assigned (1:1) to receive a monotherapy agent of clopidogrel 75 mg once daily or aspirin 100 mg once daily for 24 months. The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and Bleeding Academic Research Consortium (BARC) bleeding type 3 or greater, in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT02044250. Findings Between March 26, 2014, and May 29, 2018, we enrolled 5530 patients. 5438 (98.3%) patients were randomly assigned to either the clopidogrel group (2710 [49.8%]) or to the aspirin group (2728 [50.2%]). Ascertainment of the primary endpoint was completed in 5338 (98.2%) patients. During 24-month follow-up, the primary outcome occurred in 152 (5.7%) patients in the clopidogrel group and 207 (7.7%) in the aspirin group (hazard ratio 0.73 [95% CI 0.59-0.90]; p=0.0035). Interpretation Clopidogrel monotherapy, compared with aspirin monotherapy during the chronic maintenance period after percutaneous coronary intervention with DES significantly reduced the risk of the composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and BARC bleeding type 3 or greater. In patients requiring indefinite antiplatelet monotherapy after percutaneous coronary intervention, clopidogrel monotherapy was superior to aspirin monotherapy in preventing future adverse clinical events. Copyright (C) 2021 Elsevier Ltd. All rights reserved.
Files in This Item
There are no files associated with this item.
Appears in
Collections
Graduate School > Department of Biomedical Sciences > 1. Journal Articles

qrcode

Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.

Related Researcher

Researcher Rha, Seung Woon photo

Rha, Seung Woon
의과학과
Read more

Altmetrics

Total Views & Downloads

BROWSE