{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:40:58Z","timestamp":1791232858069,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Clopidogrel may have ischemic benefit over aspirin as long-term monotherapy in patients receiving percutaneous coronary intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Both the STOPDAPT-2 (Short and Optimal Duration of Dual Antiplatelet Therapy-2) and STOPDAPT-2 ACS (Short and Optimal Duration of Dual Antiplatelet Therapy-2 Study for the Patients With Acute Coronary Syndrome) were multicenter, open-label, adjudicator-blinded, randomized clinical trials in Japan, with the same protocol except that the STOPDAPT-2 ACS enrolled patients with acute coronary syndrome, exclusively. The patients after percutaneous coronary intervention with cobalt-chromium everolimus-eluting stents were randomized into 1-month dual antiplatelet therapy followed by clopidogrel monotherapy (clopidogrel group) or 12-month dual antiplatelet therapy followed by aspirin monotherapy (aspirin group). Follow-up duration was 5 years. The clinical effect between clopidogrel and aspirin monotherapy was compared by the 1-year landmark analysis in the STOPDAPT-2 ACS and STOPDAPT-2 total cohort, a pooled cohort of the 2 trials. The primary end point was the composite of cardiovascular end point (cardiovascular death, myocardial infarction, stroke, or definite stent thrombosis) and bleeding end point (Thrombolysis in Myocardial Infarction major\/minor). The major secondary end points were each of the cardiovascular composite end point and the bleeding end point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of 2986 patients (clopidogrel group: 1492, aspirin group: 1494) in the 5-year analysis of the STOPDAPT-2 ACS, 2875 (96.3%) completed follow-up. By the 1-year landmark analysis, clopidogrel group was superior to aspirin group for both the primary end point (6.18% and 8.27%; hazard ratio, 0.75 [95% CI, 0.57\u20130.997];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.048) and the major secondary cardiovascular end point (4.73% and 6.77%; hazard ratio, 0.70 [95% CI, 0.51\u20130.96];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.03). In the STOPDAPT-2 total cohort, including 5991 patients, the superiority of clopidogrel over aspirin for the cardiovascular end point was highly significant (hazard ratio, 0.74 [95% CI, 0.60\u20130.91];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.004), although the superiority on the primary end point was insignificant (hazard ratio, 0.86 [95% CI, 0.72\u20131.03];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.11). There was no between-groups difference in the major secondary bleeding end point, both in the STOPDAPT-2 ACS and STOPDAPT-2 total cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Clopidogrel monotherapy was superior to aspirin monotherapy for cardiovascular outcomes beyond 1 year after percutaneous coronary intervention, without increased bleeding risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT02619760 and NCT03462498.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.125.016280","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T09:00:28Z","timestamp":1773824428000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Clopidogrel Versus Aspirin Monotherapy Beyond 1 Year After PCI: The Final 5-Year Results of the STOPDAPT-2 ACS and STOPDAPT-2 Total Cohort"],"prefix":"10.1161","volume":"19","clinical-trial-number":[{"clinical-trial-number":"nct02619760","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03462498","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9443-5915","authenticated-orcid":true,"given":"Hirotoshi","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hirakata Kohsai Hospital, Japan (H.W., Takeshi Kimura)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6844-739X","authenticated-orcid":true,"given":"Takeshi","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Data Science, Hyogo Medical University, Nishinomiya, Japan (T.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Natsuaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Saga University, Japan (M.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9291-9617","authenticated-orcid":true,"given":"Ko","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan (K.Y., K.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0387-8877","authenticated-orcid":true,"given":"Yuki","family":"Obayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan (Y. Obayashi, R.N., K.I., K.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5038-1292","authenticated-orcid":true,"given":"Ryusuke","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan (Y. Obayashi, R.N., K.I., K.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5575-9035","authenticated-orcid":true,"given":"Tomoya","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mitsubishi Kyoto Hospital, Japan (Tomoya Kimura)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Imada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan (Y. Obayashi, R.N., K.I., K.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7614-0937","authenticated-orcid":true,"given":"Satoru","family":"Suwa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan (S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1271-0344","authenticated-orcid":true,"given":"Tsuyoshi","family":"Isawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sendai Kousei Hospital, Japan (T.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-4248","authenticated-orcid":true,"given":"Kenji","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan (K.Y., K.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4948-9989","authenticated-orcid":true,"given":"Takanari","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2845-9561","authenticated-orcid":true,"given":"Kazushige","family":"Kadota","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kurashiki Central Hospital, Japan (K. Kadota)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Tokuyama","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kawaguchi Cardiovascular and Respiratory Hospital, Japan (H.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7683-1578","authenticated-orcid":true,"given":"Hiroki","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shizuoka General Hospital, Japan (H. Sakamoto)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Showa Medical University Fujigaoka Hospital, Yokohama, Japan (H. Suzuki)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4264-0439","authenticated-orcid":true,"given":"Kohei","family":"Wakabayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center, Showa Medical University Koto Toyosu Hospital, Tokyo, Japan (K.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4163-980X","authenticated-orcid":true,"given":"Koh","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan (Y. Obayashi, R.N., K.I., K.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3062-3981","authenticated-orcid":true,"given":"Fujio","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Osaka Red Cross Hospital, Japan (F.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1312-5489","authenticated-orcid":true,"given":"Kengo","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan (K.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2348-7646","authenticated-orcid":true,"given":"Masaharu","family":"Akao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kyoto Medical Center, Japan (M.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7824-6911","authenticated-orcid":true,"given":"Yuko","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hiratsuka Kyosai Hospital, Japan (Y. Onishi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1693-7389","authenticated-orcid":true,"given":"Ruka","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital (R.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Kusuyama","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tsukazaki Hospital, Himeji, Japan (Takanori Kusuyama)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8655-0203","authenticated-orcid":true,"given":"Toshihiro","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tenri Hospital, Japan (T.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiro","family":"Onoue","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hitoyoshi Medical Center, Japan (Y. 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