Evidence map›Paper›PMID 34523115›Full record

Trial reportCardiology journal2021

P2Y12 inhibitor monotherapy in complex percutaneous coronary intervention: A post-hoc analysis of SMART-CHOICE randomized clinical trial.

Ji Woong Roh, Joo-Yong Hahn, Ju-Hyeon Oh, Woo Jung Chun, Yong Hwan Park, Woo Jin Jang, Eul-Soon Im, Jin-Ok Jeong, Byung Ryul Cho, Seok Kyu Oh and 22 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Cardiology journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Duration of dual antiplatelet therapy and risk of stent thrombosis in patients undergoing complex PCI: a meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  6. Antithrombotic therapy in complex percutaneous coronary intervention.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025
    Review
  7. P2YNature reviews. Cardiology · 2022
    Review
  8. Review
  9. Review
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

32 authors.

Ji Woong RohDivision of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic Of.
Joo-Yong HahnDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.
Ju-Hyeon OhDivision of Cardiology, Samsung Changwon Hospital, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Korea, Republic Of.
Woo Jung ChunDivision of Cardiology, Samsung Changwon Hospital, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Korea, Republic Of.
Yong Hwan ParkDivision of Cardiology, Samsung Changwon Hospital, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Korea, Republic Of.
Woo Jin JangDivision of Cardiology, Department of Internal Medicine, Ewha Womans University Medical Center Seoul Hospital, Seoul, Korea, Republic Of.
Eul-Soon ImDivision of Cardiology, Dongsuwon General Hospital, Suwon, Korea, Republic Of.
Jin-Ok JeongDepartment of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea, Republic Of.
Byung Ryul ChoDivision of Cardiology, Kangwon National University Hospital, Chuncheon, Korea, Republic Of.
Seok Kyu OhDepartment of Cardiology, Wonkwang University School of Medicine, Iksan, Korea, Republic Of.
Kyeong Ho YunDepartment of Cardiology, Wonkwang University School of Medicine, Iksan, Korea, Republic Of.
Deok-Kyu ChoDivision of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic Of.
Jong-Young LeeDivision of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea, Republic Of.
Young-Youp KohDivision of Cardiology, Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea, Republic Of.
Jang-Whan BaeDepartment of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea, Republic Of.
Jae Woong ChoiDepartment of Cardiology, Seoul Eulji Hospital, Eulji University College of Medicine, Seoul, Korea, Republic Of.
Wang Soo LeeDepartment of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea, Republic Of.
Hyuck Jun YoonDivision of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea, Republic Of.
Seung Uk LeeDivision of Cardiology, Kwangju Christian Hospital, Gwangju, Korea, Republic Of.
Jang Hyun ChoDivision of Cardiology, Department of Internal Medicine, Saint Carollo Hospital, Suncheon, Korea, Republic Of.
Woong Gil ChoiDivision of Cardiology, Department of Internal Medicine, Konkuk University Chungju Hospital, Konkuk University College of Medicine, Chungju, Korea, Republic Of.
Seung-Woon RhaDepartment of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea, Republic Of.
Hee-Yeol KimDivision of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic Of.
Joo Myung LeeDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.
Taek Kyu ParkDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.
Jeong Hoon YangDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.
Jin-Ho ChoiDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.
Seung-Hyuck ChoiDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.
Sang Hoon LeeDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.
Hyeon-Cheol GwonDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.
Dong-Bin KimDivision of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic Of. dbkimmd@catholic.ac.kr.
Young Bin SongDivision of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic Of.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt remains unclear whether P2Y12 monotherapy, especially clopidogrel, following short-duration dual antiplatelet therapy (DAPT) is associated with favorable outcomes in patients undergoing complex percutaneous coronary intervention (PCI). Therefore, this study analyzed the efficacy and safety of P2Y12 inhibitor monotherapy, mostly clopidogrel (78%), in complex PCI following short-term DAPT.

methodsThe post-hoc analysis of the SMART-CHOICE trial involving 2,993 patients included 498 cases of complex PCIs, defined by at least one of the following features: 3 vessels treated, ≥ 3 stents implanted, ≥ 3 lesions treated, bifurcation with ≥ 2 stents implanted, and a total stent length of ≥ 60 mm. The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE), defined as the composite of all-cause death, myocardial infarction, and stroke. The primary safety endpoint included bleeding, defined as Bleeding Academic Research Consortium (BARC) types 2 to 5.

resultsComplex PCI group had a higher risk of MACCE (4.0% vs. 2.3%, hazard ratio [HR] = 1.74, 95% confidence interval [CI]: 1.05-2.89, p = 0.033) and a similar risk of BARC types 2-5 bleeding (2.6% vs. 2.6%, HR = 1.02, 95% CI: 0.56-1.86, p = 0.939) compared with those without complex PCIs. Patients undergoing complex PCIs, followed by P2Y12 inhibitor monotherapy and 12 months of DAPT exhibited similar rates of MACCE (3.8% vs. 4.2%, HR = 0.92, 95% CI: 0.38-2.21, p = 0.853).

conclusionsP2Y12 inhibitor monotherapy, mostly clopidogrel, following 3 months of DAPT did not increase ischemic events in patients with complex PCIs.

Indexed as

Percutaneous Coronary InterventionClopidogrelDrug Therapy, CombinationDual Anti-Platelet TherapyHemorrhageHumansPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsTreatment OutcomeClopidogrelPlatelet Aggregation InhibitorsPurinergic P2Y Receptor Antagonistsclopidogrelhigh-riskpercutaneous coronary intervention

Identifiers

PMID34523115
PMCPMC8747822

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Registered trials

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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.