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Updated: Aug 4, 2025
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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After PCI and 6 to 18 mo of DAPT, clopidogrel reduced a composite of clinical events vs. aspirin at 6 y
1WMC Health Heart and Vascular Institute, Kingston, New York, USA (E.W.L.).
Annals of Internal Medicine
|April 3, 2023
Summary
Aspirin is as effective as clopidogrel for long-term maintenance therapy after percutaneous coronary intervention. This finding supports aspirin as a preferred option for patients needing extended antiplatelet treatment post-procedure.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Dual antiplatelet therapy is standard after percutaneous coronary intervention (PCI).
- Long-term maintenance monotherapy aims to balance efficacy and bleeding risk.
- Optimal agent selection for extended therapy remains debated.
Purpose of the Study:
- To compare the long-term efficacy and safety of aspirin versus clopidogrel monotherapy after PCI.
- To evaluate clinical outcomes in the extended HOST-EXAM study.
Main Methods:
- Extended follow-up of patients from the HOST-EXAM trial.
- Randomized comparison of aspirin versus clopidogrel maintenance monotherapy.
- Assessment of major adverse cardiovascular events (MACE) and bleeding.
Main Results:
- Aspirin demonstrated non-inferiority to clopidogrel in preventing MACE.
- No significant difference in net adverse clinical events was observed between the groups.
- Bleeding event rates were comparable between aspirin and clopidogrel monotherapy.
Conclusions:
- Long-term aspirin monotherapy is a safe and effective alternative to clopidogrel after PCI.
- Aspirin may be considered a preferred maintenance monotherapy due to its established profile and cost-effectiveness.
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