PPIs were prescribed in 2,418 patients (83.1%) with the no-aspirin strategy, and in 2,695 patients (92.5%) with the aspirin strategy. In the propensity score matched cohort (no-aspirin strategy: n = 902 and aspirin strategy: n = 376), a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, or stroke more often occurred in the PPI group than in the no-PPI group with the no-aspirin strategy (7.1% vs 2.4%, P = 0.002), but not with the aspirin strategy (6.9% vs 7.4%, P = 0.817). Death also more often occurred in the PPI group than in the no-PPI group with the no-aspirin strategy, but not with the aspirin strategy. Incidence of major bleeding was not different between the groups regardless of the no-aspirin and aspirin strategies (5.5% vs 3.3%, P = 0.150, and 6.9% vs 4.3%, P = 0.278) CONCLUSIONS: PPI use was associated with higher risks of cardiovascular events and mortality without decreasing major bleeding in patients undergoing PCI with aspirin-free P2Y12 inhibitor monotherapy. (ShorT and OPtimal duration of Dual AntiPlatelet Therapy after everolimus-eluting cobalt-chromium stent-3 STOPDAPT-3; NCT04609111).
Nishikura et al. (Sat,) studied this question.