{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:09:45Z","timestamp":1777432185223,"version":"3.51.4"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients undergoing complex percutaneous coronary intervention (PCI) have a higher risk of ischemic events and often receive extended dual antiplatelet therapy (DAPT), particularly to protect against stent thrombosis (ST). The selection of an optimal DAPT strategy in this setting remains challenging given the intrinsic ischemic and bleeding risk. Previous observations have not clearly established the impact of non-standard DAPT duration regimens on ischemic events in complex PCI patients. This study aims to assess the effect of non-standard DAPT duration on ischemic events in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      We searched for randomized trials comparing DAPT duration regimens in patients undergoing complex PCI. The primary outcome was definite\/probable ST. Other outcomes were myocardial infarction (MI), all-cause death, and major bleeding. Seven trials with a total of 46,696 patients undergoing either complex (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913,469) or non-complex (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933,227) PCI were included in the analysis. In complex PCI patients, the risk of definite\/probable ST was not significantly different between the non-standard DAPT and standard DAPT groups (incidence rate ratio (IRR) 1.08; 95% confidence intervals (CI) 0.63\u20131.82). Consistently, the risk of MI (IRR 0.87; 95% CI 0.70\u20131.09), all-cause death (IRR 0.85; 95% CI 0.51\u20131.39), and major bleeding (IRR 0.63; 95% CI 0.33\u20131.19) did not differ significantly between DAPT strategies. Treatment effect for definite\/probable ST by DAPT duration strategy was independent of PCI complexity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients undergoing complex PCI, we found no significant differences in stent thrombosis, myocardial infarction, all-cause death, and major bleeding between DAPT duration strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42024617534.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                    <jats:p>\n                      Dual antiplatelet therapy duration and thrombotic risk in patients undergoing complex PCI. Association between DAPT duration and the incidence of definite or probable ST and MI in patients undergoing complex PCI. Complex PCI was defined according to the trial definitions, no restrictions were applied. Standard DAPT was defined as the conventional, non-tailored regimen with a fixed duration of 6 or 12\u00a0months. Non-standard DAPT was defined as regimens with modified duration, including extended, abbreviated, or de-escalated approaches. No significant difference in definite\/probable ST and MI between complex PCI patients treated with non-standard DAPT and those treated with standard DAPT were detected.\n                      <jats:italic>DAPT<\/jats:italic>\n                      \u00a0dual antiplatelet therapy,\n                      <jats:italic>PCI<\/jats:italic>\n                      \u00a0percutaneous coronary intervention,\n                      <jats:italic>RCT<\/jats:italic>\n                      \u00a0randomized controlled trial,\n                      <jats:italic>ST<\/jats:italic>\n                      \u00a0stent thrombosis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-02928-0","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:47:22Z","timestamp":1777376842000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Duration of dual antiplatelet therapy and risk of stent thrombosis in patients undergoing complex PCI: a meta-analysis"],"prefix":"10.1007","author":[{"given":"Fiorenzo","family":"Simonetti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Carassia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hector Alfonso","family":"Alvarez Covarrubias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Joner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Kessler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Rheude","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hendrik","family":"Sager","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Voll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moritz","family":"von Scheidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erion","family":"Xhepa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Kastrati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Cassese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"issue":"2","key":"2928_CR1","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","volume":"40","author":"FJ Neumann","year":"2019","unstructured":"Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U et al (2019) 2018 ESC\/EACTS Guidelines on myocardial revascularization. Eur Heart J 40(2):87\u2013165. https:\/\/doi.org\/10.1093\/eurheartj\/ehy394","journal-title":"Eur Heart J"},{"issue":"5","key":"2928_CR2","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1016\/j.amjcard.2019.11.034","volume":"125","author":"F Qian","year":"2020","unstructured":"Qian F, Zhong Y, Hannan EL (2020) Relation between operator and hospital volumes and long-term outcomes for percutaneous coronary intervention in New York. Am J Cardiol 125(5):694\u2013711. https:\/\/doi.org\/10.1016\/j.amjcard.2019.11.034","journal-title":"Am J Cardiol"},{"issue":"Suppl 2","key":"2928_CR3","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1007\/s00392-018-1316-1","volume":"107","author":"N Werner","year":"2018","unstructured":"Werner N, Nickenig G, Sinning JM (2018) Complex PCI procedures: challenges for the interventional cardiologist. Clin Res Cardiol 107(Suppl 2):64\u201373. https:\/\/doi.org\/10.1007\/s00392-018-1316-1","journal-title":"Clin Res Cardiol"},{"issue":"3","key":"2928_CR4","doi-asserted-by":"publisher","first-page":"e4","DOI":"10.1161\/CIR.0000000000001039","volume":"145","author":"JS Lawton","year":"2022","unstructured":"Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM et al (2022) 2021 ACC\/AHA\/SCAI guideline for coronary artery revascularization: executive summary: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 145(3):e4\u2013e17. https:\/\/doi.org\/10.1161\/CIR.0000000000001039","journal-title":"Circulation"},{"issue":"9444","key":"2928_CR5","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1016\/S0140-6736(04)17275-9","volume":"364","author":"EP McFadden","year":"2004","unstructured":"McFadden EP, Stabile E, Regar E, Cheneau E, Ong AT, Kinnaird T et al (2004) Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet 364(9444):1519\u20131521. https:\/\/doi.org\/10.1016\/S0140-6736(04)17275-9","journal-title":"Lancet"},{"issue":"10","key":"2928_CR6","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1016\/j.jcin.2014.05.017","volume":"7","author":"EJ Armstrong","year":"2014","unstructured":"Armstrong EJ, Sab S, Singh GD, Lim W, Yeo KK, Waldo SW et al (2014) Predictors and outcomes of recurrent stent thrombosis: results from a multicenter registry. JACC Cardiovasc Interv 7(10):1105\u20131113. https:\/\/doi.org\/10.1016\/j.jcin.2014.05.017","journal-title":"JACC Cardiovasc Interv"},{"key":"2928_CR7","doi-asserted-by":"publisher","unstructured":"Capodanno D, Alfonso F, Levine GN, Valgimigli M, Angiolillo DJ. ACC\/AHA versus esc guidelines on dual antiplatelet therapy: JACC guideline comparison. J Am Coll Cardiol. 2018;72(23 Pt A):2915\u201331. https:\/\/doi.org\/10.1016\/j.jacc.2018.09.057.","DOI":"10.1016\/j.jacc.2018.09.057"},{"issue":"9994","key":"2928_CR8","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1016\/S0140-6736(15)61220-X","volume":"386","author":"R Piccolo","year":"2015","unstructured":"Piccolo R, Giustino G, Mehran R, Windecker S (2015) Stable coronary artery disease: revascularisation and invasive strategies. Lancet 386(9994):702\u2013713. https:\/\/doi.org\/10.1016\/S0140-6736(15)61220-X","journal-title":"Lancet"},{"issue":"11","key":"2928_CR9","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1016\/j.jacc.2015.01.024","volume":"65","author":"R Mehran","year":"2015","unstructured":"Mehran R, Giustino G, Baber U (2015) DAPT duration after DES: what is the \u201cmandatory\u201d duration? J Am Coll Cardiol 65(11):1103\u20131106. https:\/\/doi.org\/10.1016\/j.jacc.2015.01.024","journal-title":"J Am Coll Cardiol"},{"issue":"20","key":"2928_CR10","doi-asserted-by":"publisher","first-page":"2086","DOI":"10.1016\/j.jacc.2014.09.008","volume":"64","author":"A Colombo","year":"2014","unstructured":"Colombo A, Chieffo A, Frasheri A, Garbo R, Masotti-Centol M, Salvatella N et al (2014) Second-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy: the SECURITY randomized clinical trial. J Am Coll Cardiol 64(20):2086\u20132097. https:\/\/doi.org\/10.1016\/j.jacc.2014.09.008","journal-title":"J Am Coll Cardiol"},{"issue":"23","key":"2928_CR11","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.1056\/NEJMoa1409312","volume":"371","author":"L Mauri","year":"2014","unstructured":"Mauri L, Kereiakes DJ, Yeh RW, Driscoll-Shempp P, Cutlip DE, Steg PG et al (2014) Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 371(23):2155\u20132166. https:\/\/doi.org\/10.1056\/NEJMoa1409312","journal-title":"N Engl J Med"},{"issue":"6","key":"2928_CR12","doi-asserted-by":"publisher","first-page":"E758","DOI":"10.1002\/ccd.29335","volume":"97","author":"K Yamamoto","year":"2021","unstructured":"Yamamoto K, Shiomi H, Morimoto T, Takeji Y, Yoshikawa Y, Natsuaki M et al (2021) Ischemic and bleeding risk after complex percutaneous coronary intervention in patients with or without high bleeding risk. Catheter Cardiovasc Interv 97(6):E758\u2013E770. https:\/\/doi.org\/10.1002\/ccd.29335","journal-title":"Catheter Cardiovasc Interv"},{"issue":"9","key":"2928_CR13","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1016\/j.jcin.2018.12.005","volume":"12","author":"Y Ueki","year":"2019","unstructured":"Ueki Y, Karagiannis A, Zanchin C, Zanchin T, Stortecky S, Koskinas KC et al (2019) Validation of high-risk features for stent-related ischemic events as endorsed by the 2017 DAPT guidelines. JACC Cardiovasc Interv 12(9):820\u2013830. https:\/\/doi.org\/10.1016\/j.jcin.2018.12.005","journal-title":"JACC Cardiovasc Interv"},{"key":"2928_CR14","doi-asserted-by":"publisher","unstructured":"Vrints C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J et al (2024) ESC guidelines for the management of chronic coronary syndromes. Eur Heart J 45(36):3415\u20133537. https:\/\/doi.org\/10.1093\/eurheartj\/ehae177","DOI":"10.1093\/eurheartj\/ehae177"},{"key":"2928_CR15","doi-asserted-by":"publisher","unstructured":"Zeymer U, Cully M, Hochadel M (2018) Adherence to dual antiplatelet therapy with ticagrelor in patients with acute coronary syndromes treated with percutaneous coronary intervention in real life. Results of the REAL-TICA registry. Eur Heart J Cardiovasc Pharmacother 4(4):205\u201310. https:\/\/doi.org\/10.1093\/ehjcvp\/pvy018.","DOI":"10.1093\/ehjcvp\/pvy018"},{"issue":"5","key":"2928_CR16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.120.010384","volume":"14","author":"K Yamamoto","year":"2021","unstructured":"Yamamoto K, Watanabe H, Morimoto T, Domei T, Ohya M, Ogita M et al (2021) Very short dual antiplatelet therapy after drug-eluting stent implantation in patients who underwent complex percutaneous coronary intervention: insight from the STOPDAPT-2 trial. Circ Cardiovasc Interv 14(5):e010384. https:\/\/doi.org\/10.1161\/CIRCINTERVENTIONS.120.010384","journal-title":"Circ Cardiovasc Interv"},{"issue":"1","key":"2928_CR17","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1093\/ejcts\/ezx334","volume":"53","author":"M Valgimigli","year":"2018","unstructured":"Valgimigli M, Bueno H, Byrne RA, Collet JP, Costa F, Jeppsson A et al (2018) 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. Eur J Cardiothorac Surg 53(1):34\u201378. https:\/\/doi.org\/10.1093\/ejcts\/ezx334","journal-title":"Eur J Cardiothorac Surg"},{"issue":"17","key":"2928_CR18","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.1016\/j.jacc.2016.07.760","volume":"68","author":"G Giustino","year":"2016","unstructured":"Giustino G, Chieffo A, Palmerini T, Valgimigli M, Feres F, Abizaid A et al (2016) Efficacy and safety of dual antiplatelet therapy after complex PCI. J Am Coll Cardiol 68(17):1851\u20131864. https:\/\/doi.org\/10.1016\/j.jacc.2016.07.760","journal-title":"J Am Coll Cardiol"},{"key":"2928_CR19","volume-title":"Cochrane handbook for systematic reviews of interventions","author":"JPT Higgins","year":"2022","unstructured":"Higgins JPT, Green S, Cochrane C (2022) Cochrane handbook for systematic reviews of interventions. Cochrane Collaboration, Oxford"},{"key":"2928_CR20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https:\/\/doi.org\/10.1136\/bmj.n71","journal-title":"BMJ"},{"key":"2928_CR21","doi-asserted-by":"publisher","unstructured":"Garcia-Garcia HM, McFadden EP, Farb A, Mehran R, Stone GW, Spertus J et al (2018) Standardized end point definitions for coronary intervention trials: the academic research consortium-2 consensus document. circulation 137(24):2635\u201350. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.117.029289.","DOI":"10.1161\/CIRCULATIONAHA.117.029289"},{"key":"2928_CR22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928","volume":"343","author":"JP Higgins","year":"2011","unstructured":"Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD et al (2011) The Cochrane collaboration\u2019s tool for assessing risk of bias in randomised trials. BMJ 343:d5928. https:\/\/doi.org\/10.1136\/bmj.d5928","journal-title":"BMJ"},{"issue":"7109","key":"2928_CR23","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","volume":"315","author":"M Egger","year":"1997","unstructured":"Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629\u2013634. https:\/\/doi.org\/10.1136\/bmj.315.7109.629","journal-title":"BMJ"},{"issue":"19","key":"2928_CR24","doi-asserted-by":"publisher","first-page":"2414","DOI":"10.1016\/j.jacc.2020.03.011","volume":"75","author":"G Dangas","year":"2020","unstructured":"Dangas G, Baber U, Sharma S, Giustino G, Mehta S, Cohen DJ et al (2020) Ticagrelor with or without aspirin after complex PCI. J Am Coll Cardiol 75(19):2414\u20132424. https:\/\/doi.org\/10.1016\/j.jacc.2020.03.011","journal-title":"J Am Coll Cardiol"},{"issue":"6","key":"2928_CR25","doi-asserted-by":"publisher","first-page":"855","DOI":"10.5603\/CJ.a2021.0101","volume":"28","author":"JW Roh","year":"2021","unstructured":"Roh JW, Hahn JY, Oh JH, Chun WJ, Park YH, Jang WJ et al (2021) P2Y12 inhibitor monotherapy in complex percutaneous coronary intervention: a post-hoc analysis of SMART-CHOICE randomized clinical trial. Cardiol J 28(6):855\u2013863. https:\/\/doi.org\/10.5603\/CJ.a2021.0101","journal-title":"Cardiol J"},{"issue":"31","key":"2928_CR26","doi-asserted-by":"publisher","first-page":"2595","DOI":"10.1093\/eurheartj\/ehz453","volume":"40","author":"PW Serruys","year":"2019","unstructured":"Serruys PW, Takahashi K, Chichareon P, Kogame N, Tomaniak M, Modolo R et al (2019) Impact of long-term ticagrelor monotherapy following 1-month dual antiplatelet therapy in patients who underwent complex percutaneous coronary intervention: insights from the Global Leaders trial. Eur Heart J 40(31):2595\u20132604. https:\/\/doi.org\/10.1093\/eurheartj\/ehz453","journal-title":"Eur Heart J"},{"issue":"33","key":"2928_CR27","doi-asserted-by":"publisher","first-page":"3100","DOI":"10.1093\/eurheartj\/ehac284","volume":"43","author":"M Valgimigli","year":"2022","unstructured":"Valgimigli M, Smits PC, Frigoli E, Bongiovanni D, Tijssen J, Hovasse T et al (2022) Duration of antiplatelet therapy after complex percutaneous coronary intervention in patients at high bleeding risk: a MASTER DAPT trial sub-analysis. Eur Heart J 43(33):3100\u20133114. https:\/\/doi.org\/10.1093\/eurheartj\/ehac284","journal-title":"Eur Heart J"},{"issue":"18","key":"2928_CR28","doi-asserted-by":"publisher","first-page":"2213","DOI":"10.1016\/j.jacc.2017.09.011","volume":"70","author":"RW Yeh","year":"2017","unstructured":"Yeh RW, Kereiakes DJ, Steg PG, Cutlip DE, Croce KJ, Massaro JM et al (2017) Lesion complexity and outcomes of extended dual antiplatelet therapy after percutaneous coronary intervention. J Am Coll Cardiol 70(18):2213\u20132223. https:\/\/doi.org\/10.1016\/j.jacc.2017.09.011","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"2928_CR29","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.124.014623","volume":"18","author":"JK Han","year":"2025","unstructured":"Han JK, Lee K, Park SH, Yang S, Hwang D, Kang J et al (2025) Short-term DAPT after complex PCI with third-generation DES: a post hoc analysis of the HOST-IDEA trial. Circ Cardiovasc Interv 18(5):e014623. https:\/\/doi.org\/10.1161\/CIRCINTERVENTIONS.124.014623","journal-title":"Circ Cardiovasc Interv"},{"key":"2928_CR30","doi-asserted-by":"publisher","unstructured":"Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A et al (2023) ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 44(38):3720\u20133826. https:\/\/doi.org\/10.1093\/eurheartj\/ehad191","DOI":"10.1093\/eurheartj\/ehad191"},{"issue":"11","key":"2928_CR31","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1016\/j.jcin.2012.07.012","volume":"5","author":"GD Dangas","year":"2012","unstructured":"Dangas GD, Claessen BE, Mehran R, Xu K, Fahy M, Parise H et al (2012) Development and validation of a stent thrombosis risk score in patients with acute coronary syndromes. JACC Cardiovasc Interv 5(11):1097\u20131105. https:\/\/doi.org\/10.1016\/j.jcin.2012.07.012","journal-title":"JACC Cardiovasc Interv"},{"issue":"7","key":"2928_CR32","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/j.jacc.2018.11.048","volume":"73","author":"F Costa","year":"2019","unstructured":"Costa F, Van Klaveren D, Feres F, James S, Raber L, Pilgrim T et al (2019) Dual antiplatelet therapy duration based on ischemic and bleeding risks after coronary stenting. J Am Coll Cardiol 73(7):741\u2013754. https:\/\/doi.org\/10.1016\/j.jacc.2018.11.048","journal-title":"J Am Coll Cardiol"},{"key":"2928_CR33","doi-asserted-by":"publisher","unstructured":"Leone A, Simonetti F, Avvedimento M, Angellotti D, Immobile Molaro M, Franzone A et al (2022) Ultrathin struts drug-eluting stents: a state-of-the-art review. J Pers Med 12(9). https:\/\/doi.org\/10.3390\/jpm12091378.","DOI":"10.3390\/jpm12091378"},{"issue":"2","key":"2928_CR34","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jacc.2016.10.056","volume":"69","author":"CM Gibson","year":"2017","unstructured":"Gibson CM (2017) Going polymer free and dual antiplatelet free earlier: the coevolution of stent and pharmacotherapy. J Am Coll Cardiol 69(2):172\u2013175. https:\/\/doi.org\/10.1016\/j.jacc.2016.10.056","journal-title":"J Am Coll Cardiol"},{"issue":"6","key":"2928_CR35","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.jacc.2022.11.041","volume":"81","author":"F Gragnano","year":"2023","unstructured":"Gragnano F, Mehran R, Branca M, Franzone A, Baber U, Jang Y et al (2023) P2Y(12) Inhibitor monotherapy or dual antiplatelet therapy after complex percutaneous coronary interventions. J Am Coll Cardiol 81(6):537\u2013552. https:\/\/doi.org\/10.1016\/j.jacc.2022.11.041","journal-title":"J Am Coll Cardiol"},{"issue":"3","key":"2928_CR36","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1093\/ehjcvp\/pvac071","volume":"9","author":"J Nicolas","year":"2023","unstructured":"Nicolas J, Dangas G, Chiarito M, Pivato CA, Spirito A, Cao D et al (2023) Efficacy and safety of P2Y12 inhibitor monotherapy after complex PCI: a collaborative systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother 9(3):240\u2013250. https:\/\/doi.org\/10.1093\/ehjcvp\/pvac071","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"2928_CR37","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.ahj.2022.10.006","volume":"255","author":"A Oliva","year":"2023","unstructured":"Oliva A, Castiello DS, Franzone A, Condorelli G, Colombo A, Esposito G et al (2023) P2Y12 Inhibitors monotherapy in patients undergoing complex vs non-complex percutaneous coronary intervention: a meta-analysis of randomized trials. Am Heart J 255:71\u201381. https:\/\/doi.org\/10.1016\/j.ahj.2022.10.006","journal-title":"Am Heart J"},{"key":"2928_CR38","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.carrev.2023.11.002","volume":"61","author":"MM Eid","year":"2024","unstructured":"Eid MM, Mostafa MR, Alabdouh A, Najim M, Mohamed S, Ziada AR et al (2024) Short duration of dual antiplatelet therapy following complex percutaneous coronary intervention: a systematic review and meta-analysis. Cardiovasc Revasc Med 61:8\u201315. https:\/\/doi.org\/10.1016\/j.carrev.2023.11.002","journal-title":"Cardiovasc Revasc Med"},{"issue":"8","key":"2928_CR39","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1161\/CIRCULATIONAHA.123.066720","volume":"149","author":"M Natsuaki","year":"2024","unstructured":"Natsuaki M, Watanabe H, Morimoto T, Yamamoto K, Obayashi Y, Nishikawa R et al (2024) An aspirin-free versus dual antiplatelet strategy for coronary stenting: STOPDAPT-3 randomized trial. Circulation 149(8):585\u2013600. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.123.066720","journal-title":"Circulation"},{"issue":"13","key":"2928_CR40","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1161\/CIRCULATIONAHA.120.049755","volume":"144","author":"HR Reynolds","year":"2021","unstructured":"Reynolds HR, Shaw LJ, Min JK, Page CB, Berman DS, Chaitman BR et al (2021) Outcomes in the ISCHEMIA trial based on coronary artery disease and ischemia severity. Circulation 144(13):1024\u20131038. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.120.049755","journal-title":"Circulation"},{"issue":"2","key":"2928_CR41","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.jcin.2013.10.017","volume":"7","author":"GBJ Mancini","year":"2014","unstructured":"Mancini GBJ, Hartigan PM, Shaw LJ, Berman DS, Hayes SW, Bates ER et al (2014) Predicting outcome in the COURAGE trial (clinical outcomes utilizing revascularization and aggressive drug evaluation): coronary anatomy versus ischemia. JACC Cardiovasc Interv 7(2):195\u2013201. https:\/\/doi.org\/10.1016\/j.jcin.2013.10.017","journal-title":"JACC Cardiovasc Interv"},{"issue":"4","key":"2928_CR42","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1001\/jamacardio.2021.5244","volume":"7","author":"H Watanabe","year":"2022","unstructured":"Watanabe H, Morimoto T, Natsuaki M, Yamamoto K, Obayashi Y, Ogita M et al (2022) Comparison of clopidogrel monotherapy after 1 to 2 months of dual antiplatelet therapy with 12 months of dual antiplatelet therapy in patients with acute coronary syndrome: the STOPDAPT-2 ACS randomized clinical trial. JAMA Cardiol 7(4):407\u2013417. https:\/\/doi.org\/10.1001\/jamacardio.2021.5244","journal-title":"JAMA Cardiol"},{"key":"2928_CR43","doi-asserted-by":"publisher","unstructured":"Ezenna C, Krishna MM, Joseph M, Ibrahim S, Pereira V, Jenil-Franco A et al (2025) Optical coherence tomography vs. angiography alone to guide PCI for complex lesions: a meta-analysis of randomized controlled trials. Circ Cardiovasc Interv. \nhttps:\/\/doi.org\/10.1161\/CIRCINTERVENTIONS.125.015141\u00a0","DOI":"10.1161\/CIRCINTERVENTIONS.125.015141"}],"container-title":["Clinical Research in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-026-02928-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00392-026-02928-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-026-02928-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:47:23Z","timestamp":1777376843000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00392-026-02928-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":43,"alternative-id":["2928"],"URL":"https:\/\/doi.org\/10.1007\/s00392-026-02928-0","relation":{},"ISSN":["1861-0684","1861-0692"],"issn-type":[{"value":"1861-0684","type":"print"},{"value":"1861-0692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]},"assertion":[{"value":"9 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki (2013). Given its retrospective, trial-level nature based on anonymized published data, no institutional ethical approval or informed consent was required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"S.C. reports consulting fees from SIS Medical, lecture fees from Abiomed, Astra Zeneca, SIS Medical and Teleflex, and financial support for attending meetings or travel expenses from SIS Medical, not related to the current work. F.S. reports lecture fees from Translumina GmbH, not related to the current work. H.A.A.C received lecture fees from SIS Medical AG, LifeTech and Edward Lifesciences, proctor fees from LifeTech and financial support for attending meetings or travel expenses from Abbott Vascular and LifeTech, not related to the current work. T.R. received lecture fees from SIS Medical AG and AstraZeneca, not related to the current work. F.V. reports speaker fees from AstraZeneca, Abbott and Translumina and a research grant from Bentley. M.J. reports personal fees from Abbott, personal fees from Alchimedics S.A.S., personal fees from Astra Zeneca, personal fees from Biotronik, grants and personal fees from Boston Scientific, grants and personal fees from Edwards, personal fees from Medtronic, personal fees from Recor, personal fees from TriCares, personal fees from Veryan, outside the submitted work. E.X. reports consulting services for Edwards Lifesciences, lecture fees and honoraria from AstraZeneca, Boston Scientific, SIS Medical and Translumina not related to the current work; proctor fees from Abbott Vascular and financial support for attending meetings and\/or travel expenses from Abbott Vascular and SIS Medical. The remaining authors have no conflicts of interest to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}