Coronary disease & ACS

Single vs. dual antiplatelet therapy in elderly or high bleeding risk (HBR) patients undergoing percutaneous interventions with drug-coated balloons: design and rationale of PICCOLETO IV-EPIC 38 study

Am Heart JPublished prospective, international, multicenter, investigator-driven, open-label, randomized (1:1), superiority clinical trial

Study context

Population
Elderly patients aged 75 years or older or HBR patients (Academic Research Consortium criteria) undergoing successful drug-coated balloons (DCB)-only percutaneous coronary intervention (PCI) for native coronary artery disease in vessels with a diameter between 2.0 and 4.0 mm, with chronic or acute coronary syndromesplanned enrolment
Participants
576 patients
Planned comparison
Single antiplatelet therapy (SAPT) vs dual antiplatelet therapy (DAPT) after DCB-only PCI
Primary endpoint
Net Adverse Clinical Events (NACE): composite of major adverse cardiac events (MACE) (total mortality, target vessel revascularization, spontaneous myocardial infarction) and clinically relevant bleeding events (BARC 2, 3, or 5)
Follow-up
12 months
Methodological detailsdesign and rationale (no results), randomization after successful intervention, primary analysis intention-to-treat; secondary analysis as-treated
  • Design and rationale (no results)
  • Randomization after successful intervention
  • Primary analysis intention-to-treat; secondary analysis as-treated

No results yet. This paper sets out the design of a trial; its results are to come.

Original publication

Single vs. dual antiplatelet therapy in elderly or HBR patients undergoing percutaneous interventions with drug-coated balloons: design and rationale of PICCOLETO IV-EPIC 38 study. Am Heart J. Published 23 September 2026. doi:10.1016/j.ahj.2026.107606

Summarised from the published abstract; every number is checked against it

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