Coronary disease & ACSRandomised controlled trial
Aspirin Omission at the Time of Primary Percutaneous Coronary Intervention in STEMI
- Randomised controlled trial
- multicentre
- open-label
- non-inferiority
Authors' conclusion
Among patients with STEMI who were undergoing primary PCI, low-dose prasugrel monotherapy initiated before PCI was not noninferior to DAPT for 12 months with respect to a composite of death from any cause, stroke, or myocardial infarction at 12 months.
Study context
- Population
- Patients with STEMI undergoing primary percutaneous coronary intervention (PCI), Japanfull analysis population
- Participants
- 2,216 patients
- Comparison
- Low-dose prasugrel monotherapy vs dual antiplatelet therapy (DAPT)
- Monotherapyn = 1,109
- DAPTn = 1,107reference
- Primary endpoint
- Death from any cause, stroke or MI
- Follow-up
- 12 months
Primary result
As reported in the abstract
Hazard ratio
1.34
95% CI 1.02–1.75
P = 0.40 for non-inferiority
Events by treatment group
Monotherapy vs DAPT
HR 1.34 (95% CI 1.02–1.75); P for non-inferiority = 0.40
Secondary outcomes
Definite or probable stent thrombosis
- Appeared similar in the two groups
Safety
| Outcome | Monotherapy | DAPT | HR (95% CI) | |
|---|---|---|---|---|
| Major bleeding (BARC type 3 or 5) · 12 months · major secondary outcome · Kaplan-Meier estimates | 5.6% | 8.4% | 0.66 (0.47–0.91) | |
| 0.512Hazard ratio (log scale) |
Serious adverse events
- Appeared similar in the two groups
Original publication
Aspirin Omission at the Time of Primary Percutaneous Coronary Intervention in STEMI. N Engl J Med. Published 29 August 2026. doi:10.1056/nejmoa2606997
Summarised from the published abstract; every number is checked against it