Physicians' Academy for Cardiovascular Education

Shortened DAPT after PCI with third-generation DES noninferior to 12-month DAPT

News - Mar. 7, 2023

Comparison Of 3-month Versus 12-month Dual Antiplatelet Therapy After Coronary Intervention Using The Contemporary Drug-eluting Stents With Ultrathin Struts And Advanced Polymer Technology: The Host-idea Randomized Clinical Trial

Presented at the ACC.23 by: Hyo-Soo Kim, MD, PhD - Seoul, South Korea

Introduction and methods

After PCI, current guidelines recommend dual antiplatelet therapy (DAPT) for 6 months in patients with stable ischemic heart disease and 12 months in ACS patients. The use of a third-generation drug-eluting stent (DES) with ultrathin struts and advanced polymer technology has theoretical benefits that minimize the risk of stent-related complications and may allow shortening of the default duration of DAPT. However, little is known about the effects of short-term DAPT after PCI with this type of stents.

The HOST-IDEA (Harmonizing Optimal Strategy for Treatment of coronary artery diseases – coronary Intervention with next-generation Drug-Eluting stent platforms and Abbreviated dual antiplatelet therapy) trial was a multicenter, investigator-initiated, open-label, non-inferiority, adjudicator-blinded, randomized study conducted in South Korea. In this RCT, 2013 patients with de novo stenotic lesions who underwent PCI with an Orsiro bioresorbable-polymer sirolimus-eluting stent (SES) or Coroflex ISAR polymer-free SES were randomized to receive either DAPT for 3–6 months (followed by single APT) or 12 months. The APT regimen with aspirin and/or a P2Y12 i was left to the physician’s discretion. STEMI was one of the exclusion criteria.

The primary endpoint was a net adverse clinical event (NACE), a composite outcome of cardiac death, target-vessel MI, clinically driven target lesion revascularization, stent thrombosis, and major bleeding (defined as Bleeding Academic Research Consortium type 3 or 5) at 12 months. Major secondary endpoints were target lesion failure (a composite outcome of cardiac death, target-vessel MI, or clinically driven target lesion revascularization) and major bleeding.

Main results


In patients undergoing PCI (STEMI patients excluded) using a third-generation DES with ultrathin struts and advanced polymer technology, 3 to 6-month DAPT was non-inferior to 12-month DAPT with regard to the rate of NACE at 12 months.

- Our reporting is based on the information provided at the ACC.23 -

The results of this study were simultaneously published in Circulation .

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