The impact of body mass index on antiplatelet monotherapy strategy for secondary prevention after percutaneous coronary intervention: A substudy of the HOST-EXAM trial
Authors' conclusion
In stabilized post-PCI patients, clopidogrel was associated with improved long-term outcomes compared to aspirin in overweight and obese patients.
Study context
- Population
- Stabilized post-PCI patients after uneventful DAPTper-protocol
- Participants
- 4,549 patients
- Comparison
- Clopidogrel vs aspirin as single antiplatelet therapy (SAPT) across body mass index (BMI) strata
- Primary endpoint
- Composite of:
- All-cause death
- MI
- Stroke
- ACS readmission
- Major bleeding (BARC ≥3)
- Follow-up
- Median 5.8 years
Methodological detailsper-protocol, BMI subgroup analysis
- Per-protocol
- BMI subgroup analysis
Primary result
As reported in the abstract
Primary endpoint by BMI category
Adjusted hazard ratio
0.51
overweight
Adjusted hazard ratio
0.69
obese
Further findings
| Outcome | HR |
|---|---|
| Thrombotic events by BMI categoryClopidogrel vs Aspirin · overweight | 0.43 |
| Thrombotic events by BMI categoryClopidogrel vs Aspirin · obese | 0.59 |
Adverse outcomes across increasing BMI categories
- Decreasing trend with increasing BMI; most differences attenuated after adjustment
- P for trend < 0.001
Safety
Bleeding outcomes
- No significant differences between treatment groups
Original publication
The impact of body mass index on antiplatelet monotherapy strategy for secondary prevention after percutaneous coronary intervention: A substudy of the HOST-EXAM trial. Am Heart J. Published 5 July 2025. doi:10.
Summarised from the published abstract; every number is checked against it