Key result
Aspirin-free potent P2Y12 monotherapy after ACS PCI yields ~4% 1-year target vessel failure.
Why the study?
Does an aspirin-free strategy with potent P2Y12 inhibitor monotherapy prevent target vessel failure and bleeding in patients with ACS undergoing PCI?
Cohort (n=228)
Open-label
No
Does an aspirin-free strategy with potent P2Y12 inhibitor monotherapy prevent target vessel failure and bleeding in patients with ACS undergoing PCI?
An aspirin-free strategy immediately post-PCI with continuation of potent P2Y12 inhibitor monotherapy is feasible and associated with low rates of ischemic and major bleeding events in ACS patients.
Supports feasibility of aspirin-free P2Y12 monotherapy post-PCI in ACS but should not change practice; leaves open randomized confirmation of outcomes.
An aspirin-free strategy following a single loading dose with continuation of potent P2Y12 inhibitor monotherapy was feasible in patients with ACS undergoing PCI and was associated with low rates of thrombotic and major bleeding events. These findings should be regarded as hypothesis-generating and supporting further evaluations in adequately powered randomized controlled trials (CRIS registration: KCT 0008182).
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Joo et al. (2026) conducted a cohort in Acute Coronary Syndrome (ACS) undergoing PCI (n=228). Aspirin-free strategy with potent P2Y12 inhibitor monotherapy (ticagrelor or prasugrel) was evaluated on Target vessel failure (TVF) at 12 months (composite of cardiac death, target vessel-dependent MI, and target vessel revascularization) (95% CI 2.1%-7.9%). An aspirin-free strategy with potent P2Y12 inhibitor monotherapy after PCI in patients with acute coronary syndrome was feasible, resulting in a 1-year target vessel failure rate of 4.4% and infrequent major bleeding.
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