6/29/23, 11:44 PM SMART-CHOICE (3-year follow-up) Pathway Feedback Search Clinical Topics Home Studies SMART CHOICE 3-year follow-up) SMART CHOICE 3-year follow-up) Disease Disease Disease Coronary artery disease Non-ST-elevation myocardial inf ST-elevat Trial question Is P2Y12 inhibitor monotherapy after short-term dual antiplatelet therapy noninferior to long-term dual antiplatelet therapy after 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 who underwent PCI with drug-eluting stent Key exclusion criteria: hemodynamic instability or cardiogenic shock; active bleeding; hypersensitivity/contraindication to study medications; pregnancy; noncardiac comorbid conditions with life expectancy < 2 years Interventions N=1495 P2Y12 inhibitor monotherapy (P2Y12 inhibitor monotherapy after 3 months of dual antiplatelet therapy) N=1498 prolonged dual antiplatelet therapy (extended use of dual antiplatelet therapy up to 36 months) https://web.pathway.md/studies/recRbsOf0R882zuuW 1/2 6/29/23, 11:44 PM SMART-CHOICE (3-year follow-up) Pathway Primary outcome Major adverse cardiac and cerebrovascular events at 3 years 6.3 % 6.3 6.1 4.7 % 3.1 % Difference not exceeding nonferiority margin 1.6 % 0.0 % P2Y12 inhibitor monotherapy Prolonged dual antiplatelet therapy Difference not exceeding nonferiority margin in major adverse cardiac and cerebrovascular events at 3 years (6.3% vs. 6.1%; HR 1.06, 95% CI 0.79 to 1.44) Secondary outcomes Significant decrease in bleeding (3.2% vs. 8.2%; HR 0.39, 95% CI 0.28 to 0.55) Significant decrease in major bleeding (1.2% vs. 2.4%; HR 0.56, 95% CI 0.31 to 0.99) No significant difference in cardiac death (2.2% vs. 2%; HR 1.12, 95% CI 0.68 to 1.89) Conclusion In patients who underwent PCI with drug-eluting stent, P2Y12 inhibitor monotherapy was noninferior to prolonged dual antiplatelet therapy with respect to major adverse cardiac and cerebrovascular events at 3 years. Reference Ki Hong Choi, Yong Hwan Park, Young Bin Song et al. Long-term Effects of P2Y12 Inhibitor Monotherapy After Percutaneous Coronary Intervention: 3-Year Follow-up of the SMART-CHOICE Randomized Clinical Trial. JAMA Cardiol. 2022 Nov 1;7(11):1100-1108. Open reference URL https://web.pathway.md/studies/recRbsOf0R882zuuW 2/2