Study Background and Disease Burden
Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is a cornerstone treatment for coronary artery disease (CAD), especially in patients with acute coronary syndrome (ACS). Post-PCI, dual antiplatelet therapy (DAPT)—typically aspirin combined with a P2Y12 inhibitor—is recommended to reduce thrombotic complications such as stent thrombosis and recurrent ischemic events. However, prolonged DAPT increases bleeding risk, particularly in patients with high bleeding risk (HBR). Recent clinical practice has evolved towards shortening DAPT duration followed by monotherapy to balance ischemic protection and bleeding risk.
Until recently, no randomized controlled trial had directly compared aspirin monotherapy against P2Y12 inhibitor monotherapy after abbreviated DAPT following PCI. This knowledge gap is critical given the widespread use of aspirin historically, whereas P2Y12 inhibitors such as clopidogrel have emerged as alternative monotherapies with potentially different efficacy and safety profiles. The STOPDAPT-3 trial addresses this gap by evaluating the outcomes of aspirin versus clopidogrel monotherapy after short DAPT, focusing on cardiovascular and bleeding events over a one-year period.
