OCT-guided percutaneous coronary intervention (PCI) showed comparable safety and effectiveness to IVUS-guided PCI in patients with and without acute coronary syndrome (ACS), despite increased procedural complexity and contrast use with OCT.
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In ACS patients treated with drug-coated stents, a 1-month prasugrel-based DAPT strategy followed by prasugrel 5 mg monotherapy reduced net adverse clinical events by 49% compared to 12-month DAPT, primarily by lowering bleeding events without increasing ischaemic risk.
The 4D-ACS trial suggests that a shorter DAPT course followed by low-dose prasugrel monotherapy can reduce bleeding risk without compromising ischemic outcomes in ACS patients undergoing PCI.
The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)