Coronary disease & ACSSecondary analysis
Comparison of Antiplatelet Monotherapies After Percutaneous Coronary Intervention According to Clinical, Ischemic, and Bleeding Risks
- Secondary analysis of the HOST-EXAM randomised trial
- post hoc analysis
Authors' conclusion
The beneficial effect of clopidogrel over aspirin monotherapy was consistent regardless of clinical risk or relative ischemic and bleeding risks compared with aspirin monotherapy.
Study context
- Population
- Patients event free for 6 to 18 months post-PCI on dual antiplatelet therapy (DAPT)
- Participants
- 5,403 participants
- Comparison
- Clopidogrel vs aspirin monotherapy
- Primary endpoint
- Composite of:
- All-cause death
- Nonfatal MI
- Stroke
- Readmission for ACS
- Major bleeding (BARC type ≥3)
- Follow-up
- 2 years after randomization
Primary result
As reported in the abstract
Primary composite endpoint, by TRS 2°P and DAPT score (subgroups)
Clopidogrel vs AspirinHazard ratio (95% CI)
high TRS 2°P (≥3)
0.65(0.44–0.96)
low TRS 2°P (<3)
0.77(0.60–0.99)
high DAPT score (≥2)
0.68(0.46–1.00)
low DAPT score (<2)
0.75(0.59–0.96)
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Primary composite endpoint, overall · 2 years | 0.73 (0.59–0.90) | |
| 0.512Hazard ratio (log scale) |
Individual outcomes
- The association was similar for the individual outcomes
Original publication
Comparison of Antiplatelet Monotherapies After Percutaneous Coronary Intervention According to Clinical, Ischemic, and Bleeding Risks. J Am Coll Cardiol. Published 17 October 2023. doi:10.1016/j.jacc.2023.07.031
Summarised from the published abstract; every number is checked against it