Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention: 10-year follow-up of the HOST-EXAM trial
Primary resultResult — go to the resultHazard ratio 0.86 95% CI 0.77–0.96Authors' conclusion
During 10 years of follow-up, clopidogrel monotherapy, compared with aspirin monotherapy, was associated with lower rates of the primary composite, ischaemic, and bleeding outcomes, but not all-cause mortality after PCI.
Study context
- Population
- Patients who completed DAPT without clinical events for 6–18 months after percutaneous coronary intervention (PCI)completion rate 92.8%
- Participants
- 5,438 patients
- Comparison
- Clopidogrel vs aspirin monotherapy after PCI
- Clopidogreln = 2,710
- Aspirinn = 2,728reference
- Primary endpoint
- Composite of:
- All-cause death
- Non-fatal MI
- Stroke
- Readmission due to ACS
- BARC type ≥3 bleeding
- Follow-up
- Median 10.5 years (IQR 9.4-11.4)
Methodological detailsinvestigator-initiated, 10-year extended follow-up
- Investigator-initiated
- 10-year extended follow-up
Primary result
As reported in the abstract
Hazard ratio
0.86
95% CI 0.77–0.96
log-rank p=0.0050
By group
Clopidogrel vs Aspirin
HR 0.86 (95% CI 0.77–0.96); log-rank p=0.0050
Further findings
Thrombotic endpoint
log-rank p=0.0024
All-cause mortality
- All-cause mortality was similar between groups
Safety
Bleeding endpoint
log-rank p=0.020
Original publication
Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention: 10-year follow-up of the HOST-EXAM trial. Lancet. Published 29 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it