{"id":368466,"date":"2026-04-07T21:36:10","date_gmt":"2026-04-07T21:36:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/nz\/368466\/"},"modified":"2026-04-07T21:36:10","modified_gmt":"2026-04-07T21:36:10","slug":"host-exam-clopidogrel-vs-aspirin-monotherapy-at-10-years-post-pci","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/nz\/368466\/","title":{"rendered":"HOST-EXAM: Clopidogrel vs. Aspirin Monotherapy at 10 Years Post PCI"},"content":{"rendered":"

Clopidogrel monotherapy after PCI was associated with a significantly lower composite risk of all-cause death, nonfatal MI, stroke, readmission for acute coronary syndrome (ACS) and major bleeding compared with aspirin monotherapy, according to 10-year follow-up results of the HOST-EXAM trial<\/a> presented as featured clinical research at ACC.26 and published simultaneously in The Lancet.<\/p>\n

Conducted between 2014-2018 at 37 sites across South Korea, the open-label HOST-EXAM trial focused on 5,438 patients (\u226520 years old; mean age, 63.5 years; 25.4% women) who had completed 6-18 months of dual antiplatelet therapy (DAPT) without adverse clinical events following PCI with a drug-eluting stent. Participants were randomized 1:1 to either clopidogrel 75 mg once daily (n=2,710) or aspirin 100 mg once daily (n=2,728).<\/p>\n

Over a median follow-up of 10.5 years, clopidogrel was associated with a lower incidence of the composite primary endpoint compared with aspirin (Kaplan-Meier estimate, 25.4% vs. 28.5%; hazard ratio [HR], 0.86).<\/p>\n

Clopidogrel was also associated with a lower rate of the thrombotic endpoint defined as cardiovascular death, ischemic stroke, ACS readmission, and stent thrombosis (17.3% vs 20%), as well as any bleeding (9.1% vs. 10.8%). Researchers said all-cause mortality was similar between both groups.<\/p>\n

In other findings, researchers said the cumulative long-term benefit of clopidogrel \u201cwas reflected in a lower number needed to treat at 10 years compared with that at two years.\u201d The treatment effect was consistent across most subgroups, with a potentially greater benefit observed among patients with chronic kidney disease. Additionally, treatment adherence was higher among those assigned to clopidogrel compared with aspirin.<\/p>\n

\u201cThese findings suggest that clopidogrel might be considered as a preferred agent for long-term antiplatelet monotherapy during the chronic maintenance phase after PCI,\u201d write Jeehoon Kang, MD, et al. They add: \u201cThe substantial reduction in the cost of clopidogrel over the past three decades, together with the positive long-term results from the current study, warrants a reappraisal of the benefits of clopidogrel over aspirin.”<\/p>\n

\u201cThis is the first study providing a long-term comparison between the two most commonly used antiplatelet agents, and it shows a sustained benefit of clopidogrel monotherapy for lifelong secondary prevention, a finding that is particularly relevant for young patients with a long life expectancy,\u201d write Mauro Chiarito, MD, and Francesco Tartaglia, MD, in an accompanying editorial<\/a>. They add that the results may contribute to a future shift in guideline recommendations, but caution that larger RCTs in more diverse populations will be essential before clopidogrel can be definitively preferred over aspirin monotherapy.<\/p>\n


\n Clinical Topics:
\n Acute Coronary Syndromes, <\/a>Invasive Cardiovascular Angiography and Intervention, <\/a>Vascular Medicine, <\/a>Interventions and ACS, <\/a>Interventions and Vascular Medicine<\/a> \n <\/p>\n


\n Keywords:
\n ACC Annual Scientific Session, ACC26, New Orleans, Acute Coronary Syndrome, Clopidogrel, Drug-Eluting Stents, Ischemic Stroke, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, Aspirin \n <\/p>\n","protected":false},"excerpt":{"rendered":"Clopidogrel monotherapy after PCI was associated with a significantly lower composite risk of all-cause death, nonfatal MI, stroke,…\n","protected":false},"author":2,"featured_media":336120,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[134,111,139,69],"class_list":{"0":"post-368466","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-health","9":"tag-new-zealand","10":"tag-newzealand","11":"tag-nz"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/368466","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=368466"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/368466\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/336120"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=368466"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=368466"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=368466"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}