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We randomised post\u2010PCI patients with HOPR after 5\u00a0days of standard dual antiplatelet therapy (DAPT) to intensified therapy with aspirin 100\u00a0mg once daily in combination with either clopidogrel 150\u00a0mg once daily, clopidogrel 75\u00a0mg once daily plus cilostazol 100\u00a0mg twice daily, ticagrelor 90\u00a0mg twice daily, or standard therapy with clopidogrel 75\u00a0mg once daily (STD) for 1\u00a0month, after which all patients were switched to standard DAPT for a further 11\u00a0months. The primary outcome was residual HOPR rate at 1\u00a0month. We screened 1724 patients with light transmission aggregation studies and randomised 434 with HOPR. At 1\u00a0month the proportion of patients with persistent HOPR was significantly lower in the intensified therapy groups compared with STD group. Compared to the group receiving STD therapy, those receiving intensified therapy had significantly lower rate of major adverse cardiovascular events (MACE) at both 1\u00a0month and 12\u00a0months with no significant increase in bleeding. In patients with post\u2010PCI HOPR, 1\u00a0month of intensified antiplatelet therapy provides greater platelet inhibition and improves outcomes without increasing bleeding.<\/jats:p><jats:p>Clinical Trial Registration URL: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>; Unique Identifier: NCT01955200.<\/jats:p>","DOI":"10.1111\/bjh.17847","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T04:04:28Z","timestamp":1633665868000},"page":"424-432","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intensified antiplatelet therapy in patients after percutaneous coronary intervention with high on\u2010treatment platelet reactivity: the OPTImal Management of Antithrombotic Agents (OPTIMA)\u20102 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