Related Experiment Video

Updated: Jun 13, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Clopidogrel Vs Aspirin Monotherapy for Secondary Prevention After Percutaneous Coronary Intervention: A Nationwide

Jun Hwan Cho1, Seng Chan You2, Hoseob Kim3

  • 1Division of Cardiology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea; Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.

JACC. Asia
|June 12, 2026
PubMed

Insights

Clopidogrel monotherapy after percutaneous coronary intervention (PCI) shows better efficacy and safety than aspirin monotherapy. This finding supports clopidogrel as a preferred long-term antiplatelet strategy post-PCI.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Long-term antiplatelet monotherapy is recommended after dual antiplatelet therapy (DAPT) for patients who underwent percutaneous coronary intervention (PCI).
  • The optimal antiplatelet agent for monotherapy in real-world settings remains unclear.
  • This study addresses the uncertainty surrounding the choice between clopidogrel and aspirin monotherapy post-PCI.

Purpose of the Study:

  • To compare the efficacy and safety of clopidogrel versus aspirin monotherapy.
  • To evaluate outcomes in stable patients following PCI.
  • To inform clinical practice regarding long-term antiplatelet strategies.

Main Methods:

  • Utilized the Korean nationwide claims and health examination database (2009-2019).
  • Identified patients treated with PCI and maintained on clopidogrel or aspirin monotherapy.
  • Assessed co-primary outcomes: major adverse cardiovascular events and major bleeding, using inverse probability of treatment weighting.

Main Results:

  • Clopidogrel monotherapy was associated with significantly lower risks of major adverse cardiovascular events (MACE) compared to aspirin.
  • Clopidogrel also demonstrated a reduced risk of major bleeding events versus aspirin.
  • Specific components of MACE, including cardiovascular death, myocardial infarction, and ischemic stroke, were lower with clopidogrel.

Conclusions:

  • Clopidogrel monotherapy appears to be a more effective and safer option than aspirin monotherapy.
  • The findings suggest clopidogrel may be the preferred agent for long-term prevention in stable post-PCI patients.
  • Treatment effects were consistent across various subgroups and durations of prior DAPT.
Abstract

Keywords:
aspirincardiovascular event, clopidogrel, dual antiplatelet therapy, percutaneous coronary intervention

Related Concept Videos

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...