Comparison of 3- to 6-Month Versus 12-Month Dual Antiplatelet Therapy After Coronary Intervention Using the Contemporary Drug-Eluting Stents With Ultrathin Struts: The HOST-IDEA Randomized Clinical Trial
Primary resultResult — go to the resultAbsolute risk difference −0.4% 95% one-sided CI -∞% to 1.1%Authors' conclusion
Among patients undergoing percutaneous coronary intervention using third-generation drug-eluting stents, 3- to 6-month DAPT was noninferior to 12-month DAPT for net adverse clinical event.
Study context
- Population
- Patients undergoing PCI with Orsiro or Coroflex ISAR sirolimus-eluting stents; STEMI excluded
- Participants
- 2,013 patients
- Comparison
- 3- to 6-month dual antiplatelet therapy (DAPT) vs 12-month DAPT after PCI with ultrathin-strut DES
- 3- to 6-month DAPTn = 1,002
- 12-month DAPTn = 1,011reference
- Primary endpoint
- Net adverse clinical event:
- Cardiac death
- Target vessel MI
- Clinically driven target lesion revascularization
- Stent thrombosis
- Major bleeding [BARC type 3 or 5]
- Follow-up
- 12 months
Methodological detailsopen-label, non-inferiority, multicentre (37 centres, South Korea)
- Open-label
- Non-inferiority
- Multicentre (37 centres, South Korea)
Primary result
As reported in the abstract
Absolute risk difference
−0.4%
95% one-sided CI -∞% to 1.1%
P < 0.001 for noninferiority
Events by treatment group
3- to 6-month DAPTvs 12-month DAPT
absolute risk difference −0.4% (95% one-sided CI -∞% to 1.1%); P < 0.001 for noninferiority
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Target lesion failure | 0.98 (0.56–1.71) | P = 0.94 | |
| 0.512Hazard ratio (log scale) |
Net adverse clinical event, by subgroup
- Treatment effect consistent across various subgroups
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Major bleeding | 0.82 (0.41–1.61) | P = 0.56 | |
| 0.512Hazard ratio (log scale) |
Original publication
Comparison of 3- to 6-Month Versus 12-Month Dual Antiplatelet Therapy After Coronary Intervention Using the Contemporary Drug-Eluting Stents With Ultrathin Struts: The HOST-IDEA Randomized Clinical Trial. Circulation. Published 5 March 2023. doi:10.
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