From 30 days to 1 year after percutaneous coronary intervention, aspirin monotherapy compared to clopidogrel monotherapy resulted in similar rates of cardiovascular events in patients with diabetes (HR 0.96).
RCT (n=5,833)
Open-label
1:1
Yes
Does aspirin monotherapy compared to clopidogrel monotherapy beyond 1 month after PCI improve cardiovascular and bleeding outcomes in patients with diabetes?
In patients with diabetes undergoing PCI, aspirin and clopidogrel monotherapy beyond 1 month yielded similar cardiovascular outcomes, though aspirin may carry a higher bleeding risk.
Effect estimate: HR 0.96 (95% CI 0.67-1.37)
Absolute Event Rate: 5.3% vs 5.6%
p-value: p=0.82
From 30 days to 1 year after PCI, cardiovascular outcomes were similar between aspirin and clopidogrel regardless of diabetes. A nominal bleeding interaction was observed; given the exploratory and underpowered subgroup analyses, this finding should be interpreted cautiously.
Kanenawa et al. (Tue,) conducted a rct in Diabetes and coronary artery disease undergoing percutaneous coronary intervention (n=5,833). Aspirin monotherapy vs. Clopidogrel monotherapy (75 mg/day) was evaluated on Coprimary cardiovascular endpoint (composite of cardiovascular death, myocardial infarction, definite stent thrombosis, or ischemic stroke) (HR 0.96, 95% CI 0.67-1.37, p=0.82). From 30 days to 1 year after percutaneous coronary intervention, aspirin monotherapy compared to clopidogrel monotherapy resulted in similar rates of cardiovascular events in patients with diabetes (HR 0.96).