![]() Similarly, STOPDAPT-2 suggested that clopidogrel monotherapy could be continued after 1 month in patients undergoing PCI for stable ischemic heart disease and ACS. Trials such as TWILIGHT have shown that it may be possible to continue ticagrelor monotherapy and drop aspirin after 3 months with no penalty in ischemic outcomes and a reduction in bleeding outcomes among patients undergoing PCI. We have seen several interesting trials in the DAPT space in the past few years. It is unclear if clopidogrel would have the same efficacy among similar patients in the United States. One caveat is that these were all East Asian patients, and clopidogrel resistance was not assessed. Bleeding was also lower with clopidogrel, although MI and stent thrombosis were similar. On extended follow-up, the benefit of clopidogrel over aspirin was sustained out to a median of 5.8 years. Benefits were noted in thrombotic and bleeding events. ![]() The results of this trial indicate that clopidogrel monotherapy is superior to aspirin monotherapy as chronic maintenance therapy among patients who had successfully completed the required duration of DAPT therapy post–DES PCI. Benefits for the primary endpoint were sustained on landmark analysis at 2 years. ![]()
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