6/29/23, 11:56 PM STOPDAPT-2 ACS Pathway Feedback Search Clinical Topics Home Studies STOPDAPT 2 ACS STOPDAPT 2 ACS Disease Disease Non-ST-elevation myocardial inf ST-elevation myocardial infarction Trial question Is clopidogrel monotherapy after 1-2 months of dual antiplatelet therapy noninferior to 12 months of dual antiplatelet therapy in patients with acute coronary syndrome? Study design Multi-center Open label RCT Population Characteristics of study participants 21.0% female N = 4136 79.0% male 4136 patients (856 female, 3280 male) Inclusion criteria: patients with acute coronary syndrome who underwent successful PCI Key exclusion criteria: requirement of OACs; medical history of intracranial hemorrhage; serious complications after PCI; intolerance to clopidogrel Interventions N=2078 short dual antiplatelet therapy (1-2 months of dual antiplatelet therapy followed by clopidogrel monotherapy) N=2091 long dual antiplatelet therapy (12 months of dual antiplatelet therapy with aspirin and clopidogrel) https://web.pathway.md/studies/reccRZ1Q7D6z98Xdn 1/2 6/29/23, 11:57 PM STOPDAPT-2 ACS Pathway Primary outcome Composite outcome of cardiovascular death, myocardial infarction, stent thrombosis, stroke, or bleeding 3.2 % 3.2 2.8 2.4 % 1.6 % Difference exceeding nonferiority margin 0.8 % 0.0 % Short dual antiplatelet therapy Long dual antiplatelet therapy Difference exceeding nonferiority margin in composite outcome of cardiovascular death, myocardial infarction, stent thrombosis, stroke, or bleeding (3.2% vs. 2.8%; HR 1.14, 95% CI 0.8 to 1.62) Secondary outcomes No significant difference in composite outcome of cardiovascular death, myocardial infarction, stent thrombosis, or stroke (2.8% vs. 1.9%; HR 1.5, 95% CI 0.99 to 2.26) Borderline significant decrease in bleeding (0.5% vs. 1.2%; HR 0.46, 95% CI 0.23 to 0.94) No significant difference in death from any cause (1.4% vs. 0.9%; HR 1.49, 95% CI 0.83 to 2.67) Conclusion In patients with acute coronary syndrome who underwent successful PCI, short dual antiplatelet therapy was not noninferior to long dual antiplatelet therapy with respect to the composite outcome of cardiovascular death, myocardial infarction, stent thrombosis, stroke, or bleeding. Reference Hirotoshi Watanabe, Takeshi Morimoto, Masahiro Natsuaki et al. Comparison of Clopidogrel Monotherapy After 1 to 2 Months of Dual Antiplatelet Therapy With 12 Months of Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome: The STOPDAPT-2 ACS Randomized Clinical Trial. JAMA Cardiol. 2022 Mar 2;e215244. Open reference URL https://web.pathway.md/studies/reccRZ1Q7D6z98Xdn 2/2