- Question
- In patients at high bleeding risk treated with a drug-eluting coronary stent, is it safe and effective to stop dual antiplatelet therapy at 1 month rather than continuing it for longer?
- Design
- Randomized, open-label (unmasked) trial with 4579 patients in the intention-to-treat population and 4434 in the per-protocol population. Randomization took place one month after stent implantation and outcomes were assessed at 335 days.
- Population
- Patients at high bleeding risk who had received a biodegradable-polymer sirolimus-eluting coronary stent.
- Intervention
- Abbreviated therapy: immediate discontinuation of dual antiplatelet therapy one month after stent implantation, continuing a single antiplatelet agent.
- Control
- Standard therapy: continuation of dual antiplatelet therapy for at least 2 additional months.
- Primary outcome
- Three ranked primary outcomes: net adverse clinical events (death from any cause, myocardial infarction, stroke, or major bleeding), major adverse cardiac or cerebral events (death from any cause, myocardial infarction, or stroke), and major or clinically relevant nonmajor bleeding.
- Results
- Net adverse clinical events occurred in 165 patients (7.5%) with abbreviated therapy and in 172 (7.7%) with standard therapy (difference, -0.23 percentage points; 95% CI, -1.80 to 1.33; P<0.001 for noninferiority). Major or clinically relevant nonmajor bleeding was lower with abbreviated therapy: 6.5% vs 9.4% (difference, -2.82 percentage points; 95% CI, -4.40 to -1.24; P<0.001 for superiority).
- Conclusion
- One month of dual antiplatelet therapy was noninferior to continuing it for at least 2 additional months for net adverse clinical events and major adverse cardiac or cerebral events, with less bleeding.
- Why it matters
- It supported shortening dual antiplatelet therapy in patients at high bleeding risk after stent implantation, reducing bleeding without increasing ischemic events.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026