ArticleJACC. Asia2026
Clopidogrel Vs Aspirin Monotherapy for Secondary Prevention After Percutaneous Coronary Intervention: A Nationwide Cohort Study.
Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clopidogrel versus aspirin monotherapy following dual antiplatelet therapy after percutaneous coronary intervention: an updated meta-analysis of 162,829 patients.European journal of clinical pharmacology · 2026Pooled it
- Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter guideline-recommended dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI), long-term antiplatelet monotherapy is advised, but the optimal agent in real-world practice remains uncertain.
objectivesThe authors aimed to compare efficacy and safety of clopidogrel versus aspirin monotherapy in stable post-PCI patients.
methodsUsing the Korean nationwide claims and health examination database, we identified PCI-treated patients maintained on clopidogrel or aspirin monotherapy between 2009 and 2019. The co-primary outcomes were major adverse cardiovascular events (a composite of cardiovascular death, myocardial infarction or ischemic stroke) and major bleeding.
resultsAmong 133,454 patients receiving DAPT, 67,652 (50.7%) continued with clopidogrel monotherapy and 65,802 (49.3%) continued with aspirin monotherapy. The median durations of DAPT and monotherapy duration were 1.0 year (IQR: 0.8-1.2) and 3.3 years (IQR: 1.3-6.2), respectively. After stabilized inverse probability of treatment weighting, clopidogrel monotherapy was associated with lower risks of major adverse cardiovascular events (HR: 0.759; 95% CI: 0.733-0.785; P < 0.0001) and major bleeding (HR: 0.895; 95% CI: 0.848-0.945; P < 0.0001) compared with aspirin monotherapy. Clopidogrel monotherapy was associated with lower risks of cardiovascular death (HR: 0.605; 95% CI: 0.573-0.638; P < 0.0001), myocardial infarction (HR: 0.921; 95% CI: 0.877-0.968; P = 0.0011), and ischemic stroke (HR: 0.674; 95% CI: 0.624-0.729; P < 0.0001) than aspirin monotherapy. The treatment effects were consistent across prespecified subgroups and DAPT durations.
conclusionsIn the stable post-PCI period, clopidogrel monotherapy may be preferred over aspirin monotherapy for long-term prevention due to its efficacy and safety.
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