Harmonizing Optimal Strategy for Treatment of coronary artery diseases – comparison of REDUCtion of prasugrEl dose or POLYmer TECHnology in ACS patients (HOST-REDUCE-POLYTECH-ACS RCT): study protocol for a randomized controlled trial

3,384 Asian adults (≥18 years) with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) for a culprit lesion with >50% stenosis. Key exclusions: hypersensitivity/contraindication to study drugs, active bleeding, life expectancy <1 year.

Prasugrel 5 mg oral daily maintenance dose (after 1 month of 10 mg daily) and/or Platinum-chromium everolimus-eluting stent (PtCr-EES)

Prasugrel 10 mg oral daily maintenance dose (after 1 month of 10 mg daily) and/or Biodegradable polymer biolimus-eluting stent (BP-BES)

Stent arm: Patient-oriented composite outcome (all-cause mortality, any myocardial infarction, any repeat revascularization) at 12 months. Prasugrel arm: Major adverse cardiovascular event (all-cause mortality, any myocardial infarction, any stent thrombosis, any repeat revascularization, stroke, or BARC class ≥2 bleeding) at 12 months.composite