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September 5, 2025New England Journal of Medicine

Early Withdrawal of Aspirin after PCI in Acute Coronary Syndromes

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Authors

PGPatrícia O. GuimarãesMFMarcelo FrankenCTCaio A.M. Tavares

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Overview

Randomized trial assesses outcomes of P2Y12 inhibitor monotherapy versus dual antiplatelet therapy in acute coronary syndromes, indicating bleeding risks.

Key Points

  • P2Y12 inhibitor monotherapy in acute coronary syndrome patients had a higher composite outcome of death and ischemic events compared to dual therapy.
  • In the monotherapy group, 7.0% faced death, myocardial infarction, or urgent revascularization, versus 5.5% in dual therapy, showing noninferiority was not met.
  • Major bleeding was less frequent in the monotherapy group (2.0%) compared to dual therapy (4.9%), suggesting safety benefits in bleeding risk.
  • Overall, P2Y12 inhibitor monotherapy was not noninferior to dual antiplatelet therapy for acute coronary syndrome patients undergoing PCI.

Cite This Study

Guimarães et al. (2025) studied this question.

synapsesocial.com/papers/68c23966b210217d6477b943https://doi.org/10.1056/nejmoa2507980
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-label, randomised superiority trial2018 · 797 citations
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