Physicians' Academy for Cardiovascular Education

Non-inferiority criteria not met for one-month DAPT after stenting in ACS

News - Aug. 30, 2021

STOPDAPT-2 ACS: one-month dual antiplatelet therapy followed by clopidogrel monotherapy in acute coronary syndrome

Presented at the ESC congress 2021 by: Hirotoshi Watanabe, MD, PhD Kyoto, Japan

Introduction and methods

The STOPDAPT-2 ACS trial was designed to examine efficacy and safety of 1-month DAPT followed by clopidogrel monotherapy compared with standard 12-months DAPT with aspirin and clopidogrel after implantation of CoCr-EES stent in ACS patients. This trial was a multicenter, open-label RCT in Japan. The study protocol was the same as of STOPDAPT-2 but now exclusively with ACS patients. Primary endpoint was the net outcome of CV events (composite of CV death, MI, stent thrombosis and stroke) and bleeding (TIMI major and minor).

A total of 4169 ACS patients (including 1161 from previous STOPDAPT-2 trial) were randomized to 1-month DAPT or 12-month DAPT.

Main results


1-Month DAPT followed by clopidogrel monotherapy was not noninferior to 12-months DAPT with regard to net benefit in ACS patients after stent implantation.

Prof. Watanabe said that in ACS patients clopidogrel monotherapy may not be the optimal medication, but more potent P2Y12 inhibitors, such as prasugrel or ticagrelor, may have to be used as monotherapy after DAPT discontinuation.

- Our reporting is based on the information provided at the ESC Congress -

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