{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:40:35Z","timestamp":1777887635787,"version":"3.51.4"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To compare the prognostic effects of different single antiplatelet therapy (SAPT) regimens (aspirin vs. clopidogrel) in patients with acute coronary syndrome (ACS) at high-risk for ischemia and bleeding following percutaneous coronary intervention (PCI) and switching from 12 months of dual antiplatelet therapy (DAPT) to SAPT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study retrospectively analyzed 642 patients with ACS at high-risk of ischemia and bleeding who underwent PCI at a single-center between January 2017 and November 2022. After transitioning to SAPT, the cohort was divided into two groups based on the prescribed therapy: aspirin (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009435) and clopidogrel (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009207) groups. Patients were followed up for 24 months post-PCI. The primary endpoint was the occurrence of net adverse clinical events (NACE), including MACCE and major thrombolysis in myocardial infarction (TIMI) hemorrhage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of NACE was comparable between the two patient groups. However, the clopidogrel group had a lower incidence of MACCE (4.3% vs. 9.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.031) and TVR (1.4% vs. 6.4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006) compared to the aspirin group. Cox regression analysis revealed that the incidence of MACCE and TVR in the clopidogrel group were 0.458 times [\n                      <jats:italic>hazard ratio [HR]<\/jats:italic>\n                      : 0.458;\n                      <jats:italic>95% confidence interval [CI]:<\/jats:italic>\n                      0.222\u20130.944;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.034] and 0.220 times (\n                      <jats:italic>HR:<\/jats:italic>\n                      0.220;\n                      <jats:italic>95% CI:<\/jats:italic>\n                      0.067\u20130.724;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.013) that of the aspirin group, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with ACS at high-risk, transitioning to clopidogrel as SAPT after 12 months of DAPT and successful PCI was associated with a reduced incidence of MACCE and TVR compared to aspirin, without an increased risk of major bleeding events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1798099","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:19:31Z","timestamp":1777609171000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term single antiplatelet therapy for patients with acute coronary syndrome at high-risk for ischemia and bleeding: a precision cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Ma","family":"Wanda","sequence":"first","affiliation":[{"name":"Graduate School, Hebei North University","place":["Zhangjiakou, China"]},{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Mengjie","sequence":"additional","affiliation":[{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang","family":"Jingyao","sequence":"additional","affiliation":[{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun","family":"Xue","sequence":"additional","affiliation":[{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang","family":"Xiao","sequence":"additional","affiliation":[{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Cairong","sequence":"additional","affiliation":[{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Yachao","sequence":"additional","affiliation":[{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Zhigang","sequence":"additional","affiliation":[{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Zengming","sequence":"additional","affiliation":[{"name":"Langfang Core Laboratory of Precision Treatment of CAD, Langfang People\u2019s Hospital","place":["Langfang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1056\/NEJMoa010746","article-title":"Clopidogrel in unstable angina to prevent recurrent events trial investigators. 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