Prasugrel Monotherapy After Percutaneous Coronary Intervention With Biodegradable-Polymer Platinum-Chromium Everolimus Eluting Stent for Japanese Patients With Chronic Coronary Syndrome (ASET-JAPAN)

Background: P2Y12 inhibitor monotherapy without aspirin immediately after percutaneous coronary intervention (PCI) has not been tested in East Asian patients, so in this study we aimed to assess the safety and feasibility of reduced dose (3.75 mg/day) prasugrel monotherapy in Japanese patients prese...

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Published in:Circulation Journal 2023/05/25, Vol.87(6), pp.857-865
Main Authors: Muramatsu, Takashi, Masuda, Shinichiro, Kotoku, Nozomi, Kozuma, Ken, Kawashima, Hideyuki, Ishibashi, Yuki, Nakazawa, Gaku, Takahashi, Kuniaki, Okamura, Takayuki, Miyazaki, Yosuke, Tateishi, Hiroki, Nakamura, Masato, Kogame, Norihiro, Asano, Taku, Nakatani, Shimpei, Morino, Yoshihiro, Katagiri, Yuki, Ninomiya, Kai, Kageyama, Shigetaka, Takahashi, Hiroshi, Garg, Scot, Tu, Shengxian, Tanabe, Kengo, Ozaki, Yukio, Serruys, Patrick W., Onuma, Yoshinobu
Format: Article
Language:English
Subjects:
Antiplatelet monotherapy
Aspirin
Coronary artery disease
Drug-eluting stent
Drug-Eluting Stents
East Asian People
Everolimus
Hemorrhage
Humans
Japan
Percutaneous coronary intervention
Percutaneous Coronary Intervention - methods
Pilot Projects
Platinum
Polymers
Prasugrel
Prasugrel Hydrochloride - therapeutic use
Prospective Studies
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cited_by cdi_FETCH-LOGICAL-c494t-4572a71bbc1b6da77a731d37092a5a9bcc95ec52aba389f576d2c4904efe90263
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container_title Circulation Journal
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creator Muramatsu, Takashi
Masuda, Shinichiro
Kotoku, Nozomi
Kozuma, Ken
Kawashima, Hideyuki
Ishibashi, Yuki
Nakazawa, Gaku
Takahashi, Kuniaki
Okamura, Takayuki
Miyazaki, Yosuke
Tateishi, Hiroki
Nakamura, Masato
Kogame, Norihiro
Asano, Taku
Nakatani, Shimpei
Morino, Yoshihiro
Katagiri, Yuki
Ninomiya, Kai
Kageyama, Shigetaka
Takahashi, Hiroshi
Garg, Scot
Tu, Shengxian
Tanabe, Kengo
Ozaki, Yukio
Serruys, Patrick W.
Onuma, Yoshinobu
description Background: P2Y12 inhibitor monotherapy without aspirin immediately after percutaneous coronary intervention (PCI) has not been tested in East Asian patients, so in this study we aimed to assess the safety and feasibility of reduced dose (3.75 mg/day) prasugrel monotherapy in Japanese patients presenting with chronic coronary syndrome (CCS).Methods and Results: ASET-JAPAN is a prospective, multicenter, single-arm pilot study that completed enrolment of 206 patients from 12 Japanese centers in September 2022. Patients with native de-novo coronary lesions and a SYNTAX score
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Patients with native de-novo coronary lesions and a SYNTAX score &lt;23 were treated exclusively with biodegradable-polymer platinum-chromium everolimus-eluting stent(s). Patients were loaded with standard dual antiplatelet therapy (DAPT) and following successful PCI and optimal stent deployment, they received low-dose prasugrel (3.75 mg/day) monotherapy for 3 months. The primary ischemic endpoint was a composite of cardiac death, spontaneous target-vessel myocardial infarction, or definite stent thrombosis. The primary bleeding endpoint was Bleeding Academic Research Consortium (BARC) type 3 or 5. At 3-month follow-up, there were no primary bleeding or ischemic events, or any stent thrombosis.Conclusions: This pilot study showed the safety and feasibility of prasugrel monotherapy in selected low-risk Japanese patients with CCS. 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Patients with native de-novo coronary lesions and a SYNTAX score &lt;23 were treated exclusively with biodegradable-polymer platinum-chromium everolimus-eluting stent(s). Patients were loaded with standard dual antiplatelet therapy (DAPT) and following successful PCI and optimal stent deployment, they received low-dose prasugrel (3.75 mg/day) monotherapy for 3 months. The primary ischemic endpoint was a composite of cardiac death, spontaneous target-vessel myocardial infarction, or definite stent thrombosis. The primary bleeding endpoint was Bleeding Academic Research Consortium (BARC) type 3 or 5. At 3-month follow-up, there were no primary bleeding or ischemic events, or any stent thrombosis.Conclusions: This pilot study showed the safety and feasibility of prasugrel monotherapy in selected low-risk Japanese patients with CCS. 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Patients with native de-novo coronary lesions and a SYNTAX score &lt;23 were treated exclusively with biodegradable-polymer platinum-chromium everolimus-eluting stent(s). Patients were loaded with standard dual antiplatelet therapy (DAPT) and following successful PCI and optimal stent deployment, they received low-dose prasugrel (3.75 mg/day) monotherapy for 3 months. The primary ischemic endpoint was a composite of cardiac death, spontaneous target-vessel myocardial infarction, or definite stent thrombosis. The primary bleeding endpoint was Bleeding Academic Research Consortium (BARC) type 3 or 5. At 3-month follow-up, there were no primary bleeding or ischemic events, or any stent thrombosis.Conclusions: This pilot study showed the safety and feasibility of prasugrel monotherapy in selected low-risk Japanese patients with CCS. This “aspirin-free” strategy may be a safe alternative to traditional DAPT following PCI.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>36908118</pmid><doi>10.1253/circj.CJ-23-0051</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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source Medical Journals
subjects Antiplatelet monotherapy
Aspirin
Coronary artery disease
Drug-eluting stent
Drug-Eluting Stents
East Asian People
Everolimus
Hemorrhage
Humans
Japan
Percutaneous coronary intervention
Percutaneous Coronary Intervention - methods
Pilot Projects
Platinum
Polymers
Prasugrel
Prasugrel Hydrochloride - therapeutic use
Prospective Studies
title Prasugrel Monotherapy After Percutaneous Coronary Intervention With Biodegradable-Polymer Platinum-Chromium Everolimus Eluting Stent for Japanese Patients With Chronic Coronary Syndrome (ASET-JAPAN)
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