HOST-EXAM trial

This study is definitely hypothesis generating and calls for a multi national, double blind comparison on a larger scale to get a better conclusion on long term antiplatelet monotherapy after PCI with DES.  AUGUSTUS trial A somewhat similar disadvantage for aspirin was suggested in the AUGUSTUS trial among patients with atrial fibrillation and recent ACS or PCI [2]. Adding apixaban to P2Y12 inhibitor resulted in lower bleeding compared with vitamin K antagonist and a lower rate of death or rehospitalization. Addition of aspirin resulted in greater bleeding without any difference in efficacy. 92.6% of the patients in that study was on clopidogrel at randomization, while only 1.1% was on prasugrel and 6.2% on ticagrelor. But in the AUGUSTUS trial, there was no head to head comparison of aspirin vs clopidogrel or any other P2Y12 inhibitor. There was an aspirin vs placebo comparison while there was no P2Y12 inhibitor vs placebo comparison. References Koo BK, Kang J, Park KW, Rhee TM, Yang HM, Won KB, Rha SW, Bae JW, Lee NH, Hur SH, Yoon J, Park TH, Kim BS, Lim SW, Cho YH, Jeon DW, Kim SH, Han JK, Shin ES, Kim HS; HOST-EXAM investigators. Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial. Lancet. 2021 May 14:S0140-6736(21)01063-1. Alexander JH, Wojdyla D, Vora AN, Thomas L, Granger CB, Goodman SG, Aronson R, Windecker S, Me...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs