The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Aspirin-free antiplatelet regimens after PCI: when is it best to stop aspirin and who could ultimately benefit?

Eurointervention 2019; publish-ahead-of-print Oct 2019. DOI: 10.4244/EIJY19M10_01

1. Department of Cardiology, Erasmus Medical Center, Thoraxcenter, Rotterdam, the Netherlands; 2. Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom; 3. NHLI, Imperial College London, London, United Kingdom


Over the past year, an abundance of clinical evidence has emerged addressing the conceptually appealing and theoretically justified concept of dropping aspirin, rather than the P2Y12 antagonist, as part of antiplatelet regimens after percutaneous coronary intervention (PCI)1,2. In anticoagulated patients, a meta-analysis including 10,000 patients overall from WOEST, PIONEER-AF PCI, RE-DUAL PCI and AUGUSTUS indicated that omission of aspirin early after PCI allows reduction in bleeding with no significant trade-off regarding ischaemic protection3. After the publication of GLOBAL LEADERS in 2018, the year 2019 brought the results of STOPDAPT-2, SMART-CHOICE, and TWILIGHT (A Randomized Trial of Ticagrelor Monotherapy vs Ticagrelor Plus ...

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