Evidence map›Paper›PMID 30279197›Full record

Trial reportBMJ (Clinical research ed.)2018

Six months versus 12 months dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction (DAPT-STEMI): randomised, multicentre, non-inferiority trial.

Elvin Kedhi, Enrico Fabris, Martin van der Ent, Pawel Buszman, Clemens von Birgelen, Vincent Roolvink, Alexander Zurakowski, Carl E Schotborgh, Jan C A Hoorntje, Christian Hasbø Eek and 8 more

Registry-linked trialOpen access · hybridAbstract readMulticenter StudyRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01459627 (Prospective, Randomized, Open Label Trial of 6 Months vs. 12 Months Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation In ST-elevation Myocardial Infarction), which is not on this map. Cited by 71 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 13 pooled it
14.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01459627 phase4completednot on this map

Prospective, Randomized, Open Label Trial of 6 Months vs. 12 Months Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation In ST-elevation Myocardial Infarction

TypeinterventionalSponsorMaasstad HospitalRan2011 to 2017Enrolled1,100ConditionsMyocardial Infarction, Cardiovascular DiseaseArms6 months DAPT, 12 months DAPT
3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 13 syntheses or guidelines pooled it, 178 citations in OpenAlex.

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  6. Utility of the dual antiplatelet therapy score to guide antiplatelet therapy: A systematic review and meta-analysis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2021
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  13. Efficacy and Safety of Long-Term Dual Antiplatelet Therapy: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
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  20. Early discontinuation of acetylsalicylic acid after angioplasty in acute coronary syndromes: the NEO-MINDSET and TARGET-FIRST studies.European heart journal supplements : journal of the European Society of Cardiology · 2026
    Article

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 12 institutions in 5 countries.

Elvin KedhiIsala Hartcentrum, Isala Klinieken, Zwolle, Netherlands e.kedhi@isala.nl.
Enrico FabrisIsala Hartcentrum, Isala Klinieken, Zwolle, Netherlands.
Martin van der EntMaasstad Ziekenhuis, Rotterdam, Netherlands.
Pawel BuszmanAmerican Heart of Poland, Ustroń, Poland.
Clemens von BirgelenThoraxcenter, Erasmus Medisch Centrum, Rotterdam, Netherlands.
Vincent RoolvinkIsala Hartcentrum, Isala Klinieken, Zwolle, Netherlands.
Alexander ZurakowskiAmerican Heart of Poland, Chrzanów, Poland.
Carl E SchotborghHaga Hospital, The Hague, Netherlands.
Jan C A HoorntjeZuyderland Medical Centre, Heerlen, Netherlands.
Christian Hasbø EekDepartment of Cardiology, Oslo Academic University, Oslo, Norway.
Stéphane CookDepartment of Cardiology, University & Hospital, Fribourg, Switzerland.
Marco TogniDepartment of Cardiology, University & Hospital, Fribourg, Switzerland.
Martijn MeuwissenDepartment of Cardiology, Amphia Hospital, Breda, Netherlands.
Niels van RoyenDepartment of Cardiology, Radboud University Medical Centre, Nijmegen, Netherlands.
Ria van VlietMaasstad Ziekenhuis, Rotterdam, Netherlands.
Hans WedelSahlgrenska Academy, University of Gothenburg, and Nordic School of Public Health, Gothenburg, Sweden.
Ronak DelewiHeart Centre, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands.
Felix ZijlstraThoraxcenter, Erasmus Medisch Centrum, Rotterdam, Netherlands.
Isala · NLAmerican Heart of Poland · PLMaasstad Ziekenhuis · NLUniversity of Fribourg · CHAmphia Ziekenhuis · NLErasmus University Rotterdam · NLHaga Hospital · NLRadboud University Nijmegen · NLUniversity of Amsterdam · NLUniversity of Gothenburg · SEUniversity of Twente · NLZuyderland Medisch Centrum · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo show that limiting dual antiplatelet therapy (DAPT) to six months in patients with event-free ST-elevation myocardial infarction (STEMI) results in a non-inferior clinical outcome versus DAPT for 12 months.

designProspective, randomised, multicentre, non-inferiority trial.

settingPatients with STEMI treated with primary percutaneous coronary intervention (PCI) and second generation zotarolimus-eluting stent.

participantsPatients with STEMI aged 18 to 85 that underwent a primary PCI with the implantation of second generation drug-eluting stents were enrolled in the trial. Patients that were event-free at six months after primary PCI were randomised at this time point.

interventionsPatients that were taking DAPT and were event-free at six months were randomised 1:1 to single antiplatelet therapy (SAPT) (ie, aspirin only) or to DAPT for an additional six months. All patients that were randomised were then followed for another 18 months (ie, 24 months after the primary PCI).

main outcome measuresThe primary endpoint was a composite of all cause mortality, any myocardial infarction, any revascularisation, stroke, and thrombolysis in myocardial infarction major bleeding at 18 months after randomisation.

resultsA total of 1100 patients were enrolled in the trial between 19 December 2011 and 30 June 2015. 870 were randomised: 432 to SAPT versus 438 to DAPT. The primary endpoint occurred in 4.8% of patients receiving SAPT versus 6.6% of patients receiving DAPT (hazard ratio 0.73, 95% confidence interval 0.41 to 1.27, P=0.26). Non-inferiority was met (P=0.004 for non-inferiority), as the upper 95% confidence interval of 1.27 was smaller than the prespecified non-inferiority margin of 1.66.

conclusionsDAPT to six months was non-inferior to DAPT for 12 months in patients with event-free STEMI at six months after primary PCI with second generation drug-eluting stents.

trial registrationClinicaltrials.gov NCT01459627.

Indexed as

Drug-Eluting StentsAdolescentAdultAgedAged, 80 and overCombined Modality TherapyDrug Administration ScheduleFemaleHumansMaleMiddle AgedPlatelet Aggregation InhibitorsSirolimusST Elevation Myocardial InfarctionTreatment OutcomeYoung AdultPlatelet Aggregation InhibitorsSirolimuszotarolimus

Identifiers

PMID30279197
PMCPMC6167608
OpenAlexW2895104863

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.