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One vs twelve month aspirin after percutaneous coronary intervention for acute myocardial infarction: individual patient-data analysis of TARGET-FIRST and ULTIMATE-DAPT trials
Key result
Abstract reports no results comparing one-month versus twelve-month aspirin after PCI for acute MI.
Key Points
- To evaluate the safety and efficacy of 1-month versus 12-month aspirin therapy in patients undergoing percutaneous coronary intervention for acute myocardial infarction.
- Conducted a pooled individual patient-data meta-analysis using data from the TARGET-FIRST and ULTIMATE-DAPT randomized clinical trials.
- Compared ischemic and bleeding outcomes in patients receiving 1 month of aspirin followed by P2Y12 inhibitor monotherapy versus standard 12-month dual antiplatelet therapy.
- Evaluated primary composite ischemic endpoints and major bleeding events across randomized treatment arms.
- Analyzed individual patient-level data to determine the clinical trade-off between ischemic protection and bleeding risk reduction with shortened aspirin duration.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“In low-risk acute MI patients with early complete revascularization and no complications after one month of DAPT, switching to P2Y12 inhibitor monotherapy maintained protection from ischaemic events and reduced bleeding. These results reflect the benefits of modern stents, high procedural success and optimal medical therapy, making early aspirin discontinuation feasible in this selected population.”
“Our study has demonstrated that withdrawing aspirin in patients with recent ACS one month after PCI is beneficial by reducing major and minor bleeding through one year by more than 50 percent. Moreover, there was no increase in adverse ischemic events, meaning continuing aspirin was causing harm without providing any benefit.”
“I do believe that this trial in concert with all the prior trials definitely dictate a time for practice change, even before guidelines come out, because the evidence is there from dozens of randomized trials now including this one, arguably the most rigorous.”
Implication
Absence of results precludes practice change; leaves open optimal aspirin duration after AMI PCI.
Abstract
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Cite This Study
Tarantini et al. (2026) studied this question. One-month versus twelve-month aspirin after percutaneous coronary intervention for acute myocardial infarction was evaluated, but the provided abstract contains no results.