6/29/23, 11:44 PM SMART-CHOICE (1-year follow-up) Pathway Feedback Search Clinical Topics Home Studies SMART CHOICE 1-year follow-up) SMART CHOICE 1-year follow-up) Disease Disease Disease Coronary artery disease Non-ST-elevation myocardial inf ST-elevat Trial question Is P2Y12 inhibitor monotherapy noninferior to dual antiplatelet therapy in patients undergoing PCI? Study design Multi-center Open label RCT Population Characteristics of study participants 27.0% female N = 2993 73.0% male 2993 patients (795 female, 2198 male) Inclusion criteria: patients undergoing PCI with drug-eluting stents Key exclusion criteria: known hypersensitivity or contraindication to aspirin; clopidogrel; prasugrel; ticagrelor; everolimus or sirolimus Interventions N=1495 P2Y12 inhibitor monotherapy (aspirin plus a P2Y12 inhibitor for 3 months and thereafter a P2Y12 inhibitor alone) N=1498 dual antiplatelet therapy (aspirin plus a P2Y12 inhibitor for at least 12 months) Primary outcome Major adverse cardiac and cerebrovascular events at 12 months https://web.pathway.md/studies/recIYgx9u5z45VrEl 1/2 6/29/23, 11:44 PM SMART-CHOICE (1-year follow-up) Pathway 2.9 % 2.9 2.5 2.2 % 1.4 % Difference not exceeding nonferiority margin 0.7 % 0.0 % P2Y12 inhibitor monotherapy Dual antiplatelet therapy Difference not exceeding nonferiority margin in major adverse cardiac and cerebrovascular events at 12 months (2.9% vs. 2.5%; AD 0.4%, 95% CI -Infinity to 1.3) Secondary outcomes No significant difference in death from all causes (1.4% vs. 1.2%; HR 1.18, 95% CI 0.63 to 2.21) No significant difference in myocardial infarction (0.8% vs. 1.2%; HR 0.66, 95% CI 0.31 to 1.4) No significant difference in stroke (0.8% vs. 0.3%; HR 2.23, 95% CI 0.78 to 6.43) Safety outcomes No significant difference in major bleeding. Significant difference in bleeding (2.0% vs. 3.4%). Conclusion In patients undergoing PCI with drug-eluting stents, P2Y12 inhibitor monotherapy was noninferior to dual antiplatelet therapy with respect to major adverse cardiac and cerebrovascular events at 12 months. Reference Joo-Yong Hahn, Young Bin Song, Ju-Hyeon Oh et al. Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention: The SMART-CHOICE Randomized Clinical Trial. JAMA. 2019 Jun 25;321(24):2428- 2437. Open reference URL https://web.pathway.md/studies/recIYgx9u5z45VrEl 2/2