{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:07:28Z","timestamp":1792512448771,"version":"4.5.0"},"reference-count":35,"publisher":"Japanese Circulation Society","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Circ J"],"published-print":{"date-parts":[[2026,2,25]]},"DOI":"10.1253\/circj.cj-25-0356","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T22:07:25Z","timestamp":1756937245000},"page":"354-363","source":"Crossref","is-referenced-by-count":4,"title":["Aspirin-Free Prasugrel Monotherapy After Percutaneous Coronary Intervention in Patients With Non-ST Elevation Acute Coronary Syndrome"],"prefix":"10.1253","volume":"90","author":[{"given":"Kotaro","family":"Miyashita","sequence":"first","affiliation":[{"name":"School of Medicine, University of Galway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Muramatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fujita Health University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pruthvi C.","family":"Revaiah","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaku","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kindai University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Ishibashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Marianna University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Kozuma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Teikyo University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Luke International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Katagiri","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sapporo Higashi Tokushukai Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Okamura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Morino","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Iwate Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiro","family":"Kogame","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Rosai Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Luke International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimpei","family":"Nakatani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, JCHO Hoshigaoka Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Tobe","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asahi","family":"Oshima","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung","family":"Ying-Tsai","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scot","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Blackburn Hospital"},{"name":"School of Medicine, University of Central Lancashire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Mitsui Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fujita Health University Okazaki Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick W.","family":"Serruys","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Onuma","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"330","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1. Kimura K, Kimura T, Ishihara M, Nakagawa Y, Nakao K, Miyauchi K, et al. JCS 2018 Guideline on diagnosis and treatment of acute coronary syndrome. <i>Circ J<\/i> 2019; 83: 1085\u20131196.","DOI":"10.1253\/circj.CJ-19-0133"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC guidelines for the management of acute coronary syndromes. <i>Eur Heart J<\/i> 2023; 44: 3720\u20133826.","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. <i>N Engl J Med<\/i> 2001; 345: 494\u2013502.","DOI":"10.1056\/NEJMoa010746"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Baber U, Dangas G, Angiolillo DJ, Cohen DJ, Sharma SK, Nicolas J, et al. Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS. <i>Eur Heart J<\/i> 2020; 41: 3533\u20133545.","DOI":"10.1093\/eurheartj\/ehaa670"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Vranckx P, Valgimigli M, J\u00fcni P, Hamm C, Steg PG, Heg D, et al. Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: A multicentre, open-label, randomised superiority trial. <i>Lancet<\/i> 2018; 392: 940\u2013949.","DOI":"10.1016\/S0140-6736(18)31858-0"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Kim BK, Hong SJ, Cho YH, Yun KH, Kim YH, Suh Y, et al. Effect of ticagrelor monotherapy vs ticagrelor with aspirin on major bleeding and cardiovascular events in patients with acute coronary syndrome: The TICO randomized clinical trial. <i>JAMA<\/i> 2020; 323: 2407\u20132416.","DOI":"10.1001\/jama.2020.7580"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7. Hahn JY, Song YB, Oh JH, Chun WJ, Park YH, Jang WJ, et al. Effect of P2Y<sub>12<\/sub> inhibitor monotherapy vs dual antiplatelet therapy on cardiovascular events in patients undergoing percutaneous coronary intervention: The SMART-CHOICE randomized clinical trial. <i>JAMA<\/i> 2019; 321: 2428\u20132437.","DOI":"10.1001\/jama.2019.8146"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Hong SJ, Lee SJ, Suh Y, Yun KH, Kang TS, Shin S, et al. Stopping aspirin within 1 month after stenting for ticagrelor monotherapy in acute coronary syndrome: The T-PASS randomized noninferiority trial. <i>Circulation<\/i> 2024; 149: 562\u2013573.","DOI":"10.1161\/CIRCULATIONAHA.123.066943"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9. Watanabe H, Domei T, Morimoto T, Natsuaki M, Shiomi H, Toyota T, et al. Effect of 1-month dual antiplatelet therapy followed by clopidogrel vs 12-month dual antiplatelet therapy on cardiovascular and bleeding events in patients receiving PCI: The STOPDAPT-2 randomized clinical trial. <i>JAMA<\/i> 2019; 321: 2414\u20132427.","DOI":"10.1001\/jama.2019.8145"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10. Baber U, Dangas G, Angiolillo DJ, Cohen DJ, Sharma SK, Nicolas J, et al. Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS. <i>Eur Heart J<\/i> 2020; 41: 3533\u20133545.","DOI":"10.1093\/eurheartj\/ehaa670"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11. Ge Z, Kan J, Gao X, Raza A, Zhang JJ, Mohydin BS, et al. Ticagrelor alone versus ticagrelor plus aspirin from Month 1 to Month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): A randomised, placebo-controlled, double-blind clinical trial. <i>Lancet<\/i> 2024; 403: 1866\u20131878.","DOI":"10.1016\/S0140-6736(24)00473-2"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Capranzano P, Moliterno D, Capodanno D. Aspirin-free antiplatelet strategies after percutaneous coronary interventions. <i>Eur Heart J<\/i> 2024; 45: 572\u2013585.","DOI":"10.1093\/eurheartj\/ehad876"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Galli M, Laudani C, Occhipinti G, Spagnolo M, Gragnano F, D\u2019Amario D, et al. P2Y<sub>12<\/sub> inhibitor monotherapy after short DAPT in acute coronary syndrome: A systematic review and meta-analysis. <i>Eur Heart J Cardiovasc Pharmacother<\/i> 2024; 10: 588\u2013598.","DOI":"10.1093\/ehjcvp\/pvae057"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Ishida M, Shimada R, Takahashi F, Niiyama M, Ishisone T, Matsumoto Y, et al. One-month dual antiplatelet therapy followed by P2Y<sub>12<\/sub> inhibitor monotherapy after biodegradable polymer drug-eluting stent implantation: The REIWA region-wide registry. <i>Circ J<\/i> 2024; 88: 876\u2013884.","DOI":"10.1253\/circj.CJ-24-0091"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15. Small DS, Kothare P, Yuen E, Lachno DR, Li YG, Winters KJ, et al. The pharmacokinetics and pharmacodynamics of prasugrel in healthy Chinese, Japanese, and Korean subjects compared with healthy Caucasian subjects. <i>Eur J Clin Pharmacol<\/i> 2010; 66: 127\u2013135.","DOI":"10.1007\/s00228-009-0737-1"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Ogawa H, Isshiki T, Kimura T, Yokoi H, Nanto S, Takayama M, et al. Effects of <i>CYP2C19<\/i> allelic variants on inhibition of platelet aggregation and major adverse cardiovascular events in Japanese patients with acute coronary syndrome: The PRASFIT-ACS study. <i>J Cardiol<\/i> 2016; 68: 29\u201336.","DOI":"10.1016\/j.jjcc.2015.07.019"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Muramatsu T, Masuda S, Kotoku N, Kozuma K, Kawashima H, Ishibashi Y, et al. Prasugrel monotherapy after percutaneous coronary intervention with biodegradable-polymer platinum-chromium everolimus eluting stent for Japanese patients with chronic coronary syndrome (ASET-JAPAN). <i>Circ J<\/i> 2023; 87: 857\u2013865.","DOI":"10.1253\/circj.CJ-23-0051"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Masuda S, Muramatsu T, Ishibashi Y, Kozuma K, Tanabe K, Nakatani S, et al. Reduced-dose prasugrel monotherapy without aspirin after PCI with the SYNERGY stent in East Asian patients presenting with chronic coronary syndromes or non-ST-elevation acute coronary syndromes: Rationale and design of the ASET Japan pilot study. <i>AsiaIntervention<\/i> 2023; 9: 39\u201348.","DOI":"10.4244\/AIJ-D-22-00033"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. R\u00e4ber L, Mintz GS, Koskinas KC, Johnson TW, Holm NR, Onuma Y, et al. Clinical use of intracoronary imaging. Part 1: Guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. <i>Eur Heart J<\/i> 2018; 39: 3281\u20133300.","DOI":"10.1093\/eurheartj\/ehy285"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, et al. Clinical end points in coronary stent trials: A case for standardized definitions. <i>Circulation<\/i> 2007; 115: 2344\u20132351.","DOI":"10.1161\/CIRCULATIONAHA.106.685313"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Mehran R, Rao SV, Bhatt DL, Gibson CM, Caixeta A, Eikelboom J, et al. Standardized bleeding definitions for cardiovascular clinical trials: A consensus report from the Bleeding Academic Research Consortium. <i>Circulation<\/i> 2011; 123: 2736\u20132747.","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction (2018). <i>Glob Heart<\/i> 2018; 13: 305\u2013338.","DOI":"10.1016\/j.gheart.2018.08.004"},{"key":"23","doi-asserted-by":"crossref","unstructured":"23. Moussa ID, Klein LW, Shah B, Mehran R, Mack MJ, Brilakis ES, et al. Consideration of a new definition of clinically relevant myocardial infarction after coronary revascularization: An expert consensus document from the Society for Cardiovascular Angiography and Interventions (SCAI). <i>J Am Coll Cardiol<\/i> 2013; 62: 1563\u20131570.","DOI":"10.1016\/j.jacc.2013.08.720"},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Garcia-Garcia HM, McFadden EP, Farb A, Mehran R, Stone GW, Spertus J, et al. Standardized end point definitions for coronary intervention trials: The Academic Research Consortium-2 consensus document. <i>Circulation<\/i> 2018; 137: 2635\u20132650.","DOI":"10.1161\/CIRCULATIONAHA.117.029289"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Costa F, van Klaveren D, James S, Heg D, Raber L, Feres F, et al. Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: A pooled analysis of individual-patient datasets from clinical trials. <i>Lancet<\/i> 2017; 389: 1025\u20131034.","DOI":"10.1016\/S0140-6736(17)30397-5"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Valgimigli M, Garcia-Garcia HM, Vrijens B, Vranckx P, McFadden EP, Costa F, et al. Standardized classification and framework for reporting, interpreting, and analysing medication non-adherence in cardiovascular clinical trials: A consensus report from the Non-adherence Academic Research Consortium (NARC). <i>Eur Heart J<\/i> 2019; 40: 2070\u20132085.","DOI":"10.1093\/eurheartj\/ehy377"},{"key":"27","doi-asserted-by":"crossref","unstructured":"27. Natsuaki M, Watanabe H, Morimoto T, Yamamoto K, Obayashi Y, Nishikawa R, et al. An aspirin-free versus dual antiplatelet strategy for coronary stenting: STOPDAPT-3 randomized trial. <i>Circulation<\/i> 2024; 149: 585\u2013600.","DOI":"10.1161\/CIRCULATIONAHA.123.066720"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28. Yamamoto K, Natsuaki M, Watanabe H, Morimoto T, Obayashi Y, Nishikawa R, et al. An aspirin-free strategy for patients undergoing staged percutaneous coronary intervention: A subgroup analysis of the STOPDAPT-3 trial. <i>Circ Rep<\/i> 2025; 7: 451\u2013462.","DOI":"10.1253\/circrep.CR-25-0026"},{"key":"29","doi-asserted-by":"crossref","unstructured":"29. Kogame N, Guimar\u00e3es PO, Modolo R, De Martino F, Tinoco J, Ribeiro EE, et al. Aspirin-free prasugrel monotherapy following coronary artery stenting in patients with stable CAD: The ASET pilot study. <i>JACC Cardiovasc Interv<\/i> 2020; 13: 2251\u20132262.","DOI":"10.1016\/j.jcin.2020.06.023"},{"key":"30","doi-asserted-by":"crossref","unstructured":"30. van der Sangen NMR, Claessen BEPM, K\u00fc\u00e7\u00fck IT, den Hartog AW, Baan J, Beijk MAM, et al. Single antiplatelet therapy directly after percutaneous coronary intervention in non-ST-segment elevation acute coronary syndrome patients: The OPTICA study. <i>EuroIntervention<\/i> 2023; 19: 63\u201372.","DOI":"10.4244\/EIJ-D-22-00886"},{"key":"31","doi-asserted-by":"crossref","unstructured":"31. van der Sangen NMR, K\u00fc\u00e7\u00fck IT, Sivanesan S, Appelman Y, Ten Berg JM, Verburg A, et al. Less bleeding by omitting aspirin in non-ST-segment elevation acute coronary syndrome patients: Rationale and design of the LEGACY study. <i>Am Heart J<\/i> 2023; 265: 114\u2013120.","DOI":"10.1016\/j.ahj.2023.07.011"},{"key":"32","doi-asserted-by":"crossref","unstructured":"32. Guimaraes PO, Franken M, Tavares CAM, Silveira FS, Antunes MO, Bergo RR, et al. P2Y<sub>12<\/sub> inhibitor monotherapy versus dual antiplatelet therapy in patients with acute coronary syndromes undergoing coronary stenting: Rationale and design of the NEOMINDSET Trial. <i>EuroIntervention<\/i> 2023; 19: e323\u2013e329.","DOI":"10.4244\/EIJ-D-23-00125"},{"key":"33","doi-asserted-by":"crossref","unstructured":"33. Gragnano F, van Klaveren D, Heg D, R\u00e4ber L, Krucoff MW, Raposeiras-Roub\u00edn S, et al. Derivation and validation of the PRECISE-HBR score to predict bleeding after percutaneous coronary intervention. <i>Circulation<\/i> 2025; 151: 343\u2013355.","DOI":"10.1161\/CIRCULATIONAHA.124.072009"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. Urban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention. <i>Circulation<\/i> 2019; 140: 240\u2013261.","DOI":"10.1161\/CIRCULATIONAHA.119.040167"},{"key":"35","doi-asserted-by":"crossref","unstructured":"35. Watanabe H, Morimoto T, Natsuaki M, Yamamoto K, Obayashi Y, Ogita M, et al. 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. <i>JAMA Cardiol<\/i> 2022; 7: 407\u2013417.","DOI":"10.1001\/jamacardio.2021.5244"}],"container-title":["Circulation Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/circj\/90\/3\/90_CJ-25-0356\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T03:39:54Z","timestamp":1772249994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/circj\/90\/3\/90_CJ-25-0356\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1253\/circj.cj-25-0356","relation":{},"ISSN":["1346-9843","1347-4820"],"issn-type":[{"value":"1346-9843","type":"print"},{"value":"1347-4820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"article-number":"CJ-25-0356"}}