Evidence map›Paper›PMID 39056346›Full record

Trial reportJournal of the American Heart Association2024

Aspirin-Free Strategy for Percutaneous Coronary Intervention in Patients With Oral Anticoagulation: Prespecified Subgroup Analysis From the STOPDAPT-3 Trial.

Masahiro Natsuaki, Hirotoshi Watanabe, Takeshi Morimoto, Ko Yamamoto, Yuki Obayashi, Ryusuke Nishikawa, Kenji Ando, Satoru Suwa, Tsuyoshi Isawa, Hiroyuki Takenaka and 12 more

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Masahiro NatsuakiDepartment of Cardiovascular Medicine Saga University Saga Japan.
Hirotoshi WatanabeDivision of Cardiology Hirakata Kohsai Hospital Hirakata Japan.ORCID 0000-0002-9443-5915
Takeshi MorimotoDepartment of Clinical Epidemiology Hyogo College of Medicine Nishinomiya Japan.ORCID 0000-0002-6844-739X
Ko YamamotoDepartment of Cardiology Kokura Memorial Hospital Kitakyusyu Japan.ORCID 0000-0002-9291-9617
Yuki ObayashiDepartment of Cardiovascular Medicine, Graduate School of Medicine Kyoto University Kyoto Japan.ORCID 0000-0002-0387-8877
Ryusuke NishikawaDepartment of Cardiovascular Medicine, Graduate School of Medicine Kyoto University Kyoto Japan.ORCID 0000-0001-5038-1292
Kenji AndoDepartment of Cardiology Kokura Memorial Hospital Kitakyusyu Japan.ORCID 0000-0003-0699-4248
Satoru SuwaDepartment of Cardiology Juntendo University Shizuoka Hospital Izunokuni Japan.ORCID 0000-0002-7614-0937
Tsuyoshi IsawaDepartment of Cardiology Sendai Kousei Hospital Sendai Japan.ORCID 0000-0003-1271-0344
Hiroyuki TakenakaDivision of Cardiology Hirakata Kohsai Hospital Hirakata Japan.
Tetsuya IshikawaDepartment of Cardiology Dokkyo Medical University Saitama Medical Center Koshigaya Japan.ORCID 0000-0003-2765-5165
Minoru YamadaDivision of Cardiology Shizuoka Saiseikai General Hospital Shizuoka Japan.
Tetsuzo WakatsukiDepartment of Cardiovascular Medicine Tokushima University Hospital Tokushima Japan.
Yoichi NozakiDepartment of Cardiovascular Medicine Hokko Memorial Hospital Sapporo Japan.
Hideki KitaharaDepartment of Cardiovascular Medicine Chiba University Hospital Chiba Japan.ORCID 0000-0002-2888-6160
Ryuichi KatoDepartment of Cardiology Higashiyamato Hospital Higashiyamato Japan.
Ryoma KawaiDepartment of Cardiology Tenri Hospital Tenri Japan.
Yohei KobayashiDepartment of Cardiovascular Center Japanese Red Cross Osaka Hospital Osaka Japan.
Mitsuru IshiiDepartment of Cardiology Kyoto Medical Center Kyoto Japan.ORCID 0000-0002-8686-3733
Yoshitaka GotoDepartment of Cardiology Fukuoka Wajiro Hospital Fukuoka Japan.ORCID 0000-0002-8342-5578
Koh OnoDepartment of Cardiovascular Medicine, Graduate School of Medicine Kyoto University Kyoto Japan.ORCID 0000-0002-4163-980X
Takeshi KimuraDivision of Cardiology Hirakata Kohsai Hospital Hirakata Japan.ORCID 0000-0002-5665-4076

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effects of aspirin-free strategy on bleeding and cardiovascular events in patients undergoing percutaneous coronary intervention with oral anticoagulation (OAC) have not been fully elucidated. METHODS AND

resultsWe conducted the prespecified subgroup analysis based on the use of OAC, including vitamin K antagonist and direct oral anticoagulants, within 7 days before percutaneous coronary intervention in the STOPDAPT-3 (Short and Optimal Duration of Dual Antiplatelet Therapy-3) trial, which randomly compared prasugrel monotherapy (2984 patients) to dual antiplatelet therapy (DAPT) with prasugrel and aspirin (2982 patients) in patients with acute coronary syndrome or high bleeding risk. The coprimary end points were major bleeding events (Bleeding Academic Research Consortium types 3 or 5) and cardiovascular events (a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, or ischemic stroke) at 1 month. Among 5966 study patients, there were 530 patients (8.9%) with OAC (no aspirin: N=248, and DAPT: N=282) and 5436 patients (91.1%) without OAC (no aspirin: N=2736, and DAPT: N=2700). Regardless of the use of OAC, the effects of no aspirin compared with DAPT were not significant for the bleeding end point (OAC: 4.45% and 4.27%, hazard ratio [HR], 1.04 [95% CI, 0.46-2.35]; no-OAC: 4.47% and 4.75%, HR, 0.94 [95% CI, 0.73-1.20];

conclusionsThe no-aspirin strategy compared with the DAPT strategy failed to reduce major bleeding events irrespective of the use of OAC. There was a numerical excess risk of the no-aspirin strategy relative to the DAPT strategy for cardiovascular events in patients with OAC.

Indexed as

Acute Coronary SyndromeAnticoagulantsAspirinDual Anti-Platelet TherapyHemorrhagePercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPrasugrel HydrochlorideAdministration, OralAgedFemaleHumansMaleMiddle AgedRisk AssessmentRisk FactorsAnticoagulantsAspirinPlatelet Aggregation InhibitorsPrasugrel Hydrochlorideaspirin‐free strategyoral anticoagulationpercutaneous coronary intervention

Identifiers

PMID39056346
PMCPMC11964053

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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.