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September 10, 2025Circulation Journal4 citationsOpen Access

Aspirin-Free Prasugrel Monotherapy After Percutaneous Coronary Intervention in Patients With Non-ST Elevation Acute Coronary Syndrome

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KMKotaro MiyashitaTMTakashi MuramatsuPRPruthvi C. Revaiah

Key Points

  • Prasugrel monotherapy shows potential antithrombotic benefits in patients with NSTE-ACS.
  • The study reveals that aspirin's additional benefit alongside prasugrel is unclear in this patient group.
  • Assessment of prasugrel monotherapy after PCI showed feasibility in chronic coronary syndrome patients.
  • Further research is needed to confirm the outcomes of prasugrel monotherapy in diverse NSTE-ACS populations.

Abstract

Background: In the presence of a potent P2Y12inhibitor such as prasugrel, the additional clinical antithrombotic benefit of aspirin is unclear. The feasibility of prasugrel monotherapy without aspirin after percutaneous coronary intervention (PCI) has been demonstrated in chronic coronary syndrome, but is yet to be assessed in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) and low anatomical complexity.

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Cite This Study

Miyashita et al. (2025) studied this question.

synapsesocial.com/papers/68c23b4ab210217d6478495bhttps://doi.org/10.1253/circj.cj-25-0356
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Also Consider

Synapse has enriched 5 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
  2. 2An Aspirin-Free Strategy for Patients Undergoing Staged Percutaneous Coronary Intervention ― A Subgroup Analysis of the STOPDAPT-3 Trial ―2025 · 1 citations
  3. 3Prasugrel Monotherapy After Percutaneous Coronary Intervention With Biodegradable-Polymer Platinum-Chromium Everolimus Eluting Stent for Japanese Patients With Chronic Coronary Syndrome (ASET-JAPAN)2023 · 33 citations
  4. 4Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): a randomised, placebo-controlled, double-blind clinical trial2024 · 174 citations
  5. 5Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority Trial2023 · 158 citations