Dual antiplatelet therapy after percutaneous coronary intervention according to bleeding risk (HOST-BR): an open-label, multicentre, randomised clinical trial.
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| Title: | Dual antiplatelet therapy after percutaneous coronary intervention according to bleeding risk (HOST-BR): an open-label, multicentre, randomised clinical trial. |
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| Authors: | Kang, Jeehoon (AUTHOR), Park, Kyung Woo (AUTHOR), Han, Jung-Kyu (AUTHOR), Hwang, Doyeon (AUTHOR), Yang, Han-Mo (AUTHOR), Park, Sungjoon (AUTHOR), Ahn, Hyo-Suk (AUTHOR), Hwang, Kyung-Kuk (AUTHOR), Kim, Byung Gyu (AUTHOR), Jeong, Jin-Ok (AUTHOR), Ahn, Jong-Hwa (AUTHOR), Rhew, Jay Young (AUTHOR), Park, Hanbit (AUTHOR), Kang, Tae Soo (AUTHOR), Koh, Jin-Sin (AUTHOR), Park, Kyung-Taek (AUTHOR), Bang, Duk Won (AUTHOR), Goh, Choong-Won (AUTHOR), Yoon, Hyuck-Jun (AUTHOR), Jo, Sang-Ho (AUTHOR) |
| Source: | Lancet. Nov2025, Vol. 406 Issue 10516, p2244-2256. 13p. |
| Subjects: | Percutaneous coronary intervention, Drug-eluting stents, Platelet aggregation inhibitors, Adverse health care events, Hemorrhage, Major adverse cardiovascular events, Clinical trials, East Asians |
| Geographic Terms: | South Korea |
| Abstract: | The optimal duration of dual antiplatelet therapy (DAPT) after coronary stenting according to bleeding risk is not well established. We aimed to evaluate the optimal duration of DAPT after coronary stenting according to bleeding risk. In this open-label, multicentre, randomised clinical trial, patients aged 19 years and older who received percutaneous coronary intervention with a drug-eluting stent at 50 high-volume cardiology centres in South Korea were stratified into high bleeding risk (HBR) or non-HBR strata, according to Academic Research Consortium for High Bleeding Risk criteria. Patients in the HBR stratum were randomly assigned (1:1) to 1-month or 3-month DAPT, and those in the non-HBR stratum were randomly assigned (1:1) to 3-month or 12-month DAPT. The three coprimary endpoints were net adverse clinical events (all-cause death, myocardial infarction, stent thrombosis, stroke, or major bleeding), major adverse cardiac or cerebral events (cardiovascular death, myocardial infarction, definite or probable stent thrombosis, or ischaemic stroke), and any actionable non-surgical bleeding at 1 year after randomisation. Primary endpoints were assessed in hierarchical order in the intention-to-treat population. This study is registered with cris.nih.go.kr, KCT0005356, and ClinicalTrials.gov , NCT05631769 , and is complete. From July 24, 2020, to Sept 25, 2023, 4897 patients were enrolled (1598 in the HBR stratum and 3299 in the non-HBR stratum). In the HBR stratum, 1-month compared with 3-month DAPT did not reach non-inferiority for net adverse clinical events (144 [18·4%] of 798 vs 110 [14·0%] of 800 patients; hazard ratio [HR] 1·337 [95% CI 1·043–1·713]; p=0·82 for non-inferiority). Major adverse cardiac or cerebral events occurred in 74 (9·8%) patients in the 1-month DAPT group and 44 (5·8%) in the 3-month group; bleeding occurred in 105 (13·8%) patients in the 1-month group and 122 (15·8%) in the 3-month group. In the non-HBR stratum, 3-month was non-inferior to 12-month DAPT regarding net adverse clinical events (47 [2·9%] of 1649 vs 72 [4·4%] of 1650 patients; HR 0·657 [0·455–0·949]; p<0·0001 for non-inferiority) and major adverse cardiac or cerebral events (36 [2·2%] vs 37 [2·3%]; HR 0·984 [0·622–1·558]; p=0·0082 for non-inferiority), and superior for bleeding (120 [7·4%] vs 190 [11·7%]; HR 0·631 [0·502–0·793]; p<0·0001). In east Asian patients with HBR, 1-month DAPT did not reach non-inferiority to 3-month DAPT for net adverse clinical events. In patients without HBR, 3-month DAPT was non-inferior to 12-month DAPT regarding net adverse clinical events and major adverse cardiac or cerebral events, and superior for bleeding. Medtronic and Abbott. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 189149236 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Dual antiplatelet therapy after percutaneous coronary intervention according to bleeding risk (HOST-BR): an open-label, multicentre, randomised clinical trial. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Kang%2C+Jeehoon%22">Kang, Jeehoon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Park%2C+Kyung+Woo%22">Park, Kyung Woo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Han%2C+Jung-Kyu%22">Han, Jung-Kyu</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hwang%2C+Doyeon%22">Hwang, Doyeon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yang%2C+Han-Mo%22">Yang, Han-Mo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Park%2C+Sungjoon%22">Park, Sungjoon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ahn%2C+Hyo-Suk%22">Ahn, Hyo-Suk</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hwang%2C+Kyung-Kuk%22">Hwang, Kyung-Kuk</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kim%2C+Byung+Gyu%22">Kim, Byung Gyu</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jeong%2C+Jin-Ok%22">Jeong, Jin-Ok</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ahn%2C+Jong-Hwa%22">Ahn, Jong-Hwa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rhew%2C+Jay+Young%22">Rhew, Jay Young</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Park%2C+Hanbit%22">Park, Hanbit</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kang%2C+Tae+Soo%22">Kang, Tae Soo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Koh%2C+Jin-Sin%22">Koh, Jin-Sin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Park%2C+Kyung-Taek%22">Park, Kyung-Taek</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bang%2C+Duk+Won%22">Bang, Duk Won</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Goh%2C+Choong-Won%22">Goh, Choong-Won</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yoon%2C+Hyuck-Jun%22">Yoon, Hyuck-Jun</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jo%2C+Sang-Ho%22">Jo, Sang-Ho</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. Nov2025, Vol. 406 Issue 10516, p2244-2256. 13p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Percutaneous+coronary+intervention%22">Percutaneous coronary intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Drug-eluting+stents%22">Drug-eluting stents</searchLink><br /><searchLink fieldCode="DE" term="%22Platelet+aggregation+inhibitors%22">Platelet aggregation inhibitors</searchLink><br /><searchLink fieldCode="DE" term="%22Adverse+health+care+events%22">Adverse health care events</searchLink><br /><searchLink fieldCode="DE" term="%22Hemorrhage%22">Hemorrhage</searchLink><br /><searchLink fieldCode="DE" term="%22Major+adverse+cardiovascular+events%22">Major adverse cardiovascular events</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+trials%22">Clinical trials</searchLink><br /><searchLink fieldCode="DE" term="%22East+Asians%22">East Asians</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22South+Korea%22">South Korea</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: The optimal duration of dual antiplatelet therapy (DAPT) after coronary stenting according to bleeding risk is not well established. We aimed to evaluate the optimal duration of DAPT after coronary stenting according to bleeding risk. In this open-label, multicentre, randomised clinical trial, patients aged 19 years and older who received percutaneous coronary intervention with a drug-eluting stent at 50 high-volume cardiology centres in South Korea were stratified into high bleeding risk (HBR) or non-HBR strata, according to Academic Research Consortium for High Bleeding Risk criteria. Patients in the HBR stratum were randomly assigned (1:1) to 1-month or 3-month DAPT, and those in the non-HBR stratum were randomly assigned (1:1) to 3-month or 12-month DAPT. The three coprimary endpoints were net adverse clinical events (all-cause death, myocardial infarction, stent thrombosis, stroke, or major bleeding), major adverse cardiac or cerebral events (cardiovascular death, myocardial infarction, definite or probable stent thrombosis, or ischaemic stroke), and any actionable non-surgical bleeding at 1 year after randomisation. Primary endpoints were assessed in hierarchical order in the intention-to-treat population. This study is registered with cris.nih.go.kr, KCT0005356, and ClinicalTrials.gov , NCT05631769 , and is complete. From July 24, 2020, to Sept 25, 2023, 4897 patients were enrolled (1598 in the HBR stratum and 3299 in the non-HBR stratum). In the HBR stratum, 1-month compared with 3-month DAPT did not reach non-inferiority for net adverse clinical events (144 [18·4%] of 798 vs 110 [14·0%] of 800 patients; hazard ratio [HR] 1·337 [95% CI 1·043–1·713]; p=0·82 for non-inferiority). Major adverse cardiac or cerebral events occurred in 74 (9·8%) patients in the 1-month DAPT group and 44 (5·8%) in the 3-month group; bleeding occurred in 105 (13·8%) patients in the 1-month group and 122 (15·8%) in the 3-month group. In the non-HBR stratum, 3-month was non-inferior to 12-month DAPT regarding net adverse clinical events (47 [2·9%] of 1649 vs 72 [4·4%] of 1650 patients; HR 0·657 [0·455–0·949]; p<0·0001 for non-inferiority) and major adverse cardiac or cerebral events (36 [2·2%] vs 37 [2·3%]; HR 0·984 [0·622–1·558]; p=0·0082 for non-inferiority), and superior for bleeding (120 [7·4%] vs 190 [11·7%]; HR 0·631 [0·502–0·793]; p<0·0001). In east Asian patients with HBR, 1-month DAPT did not reach non-inferiority to 3-month DAPT for net adverse clinical events. In patients without HBR, 3-month DAPT was non-inferior to 12-month DAPT regarding net adverse clinical events and major adverse cardiac or cerebral events, and superior for bleeding. Medtronic and Abbott. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1016/S0140-6736(25)01571-5 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 2244 Subjects: – SubjectFull: Percutaneous coronary intervention Type: general – SubjectFull: Drug-eluting stents Type: general – SubjectFull: Platelet aggregation inhibitors Type: general – SubjectFull: Adverse health care events Type: general – SubjectFull: Hemorrhage Type: general – SubjectFull: Major adverse cardiovascular events Type: general – SubjectFull: Clinical trials Type: general – SubjectFull: East Asians Type: general – SubjectFull: South Korea Type: general Titles: – TitleFull: Dual antiplatelet therapy after percutaneous coronary intervention according to bleeding risk (HOST-BR): an open-label, multicentre, randomised clinical trial. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Kang, Jeehoon – PersonEntity: Name: NameFull: Park, Kyung Woo – PersonEntity: Name: NameFull: Han, Jung-Kyu – PersonEntity: Name: NameFull: Hwang, Doyeon – PersonEntity: Name: NameFull: Yang, Han-Mo – PersonEntity: Name: NameFull: Park, Sungjoon – PersonEntity: Name: NameFull: Ahn, Hyo-Suk – PersonEntity: Name: NameFull: Hwang, Kyung-Kuk – PersonEntity: Name: NameFull: Kim, Byung Gyu – PersonEntity: Name: NameFull: Jeong, Jin-Ok – PersonEntity: Name: NameFull: Ahn, Jong-Hwa – PersonEntity: Name: NameFull: Rhew, Jay Young – PersonEntity: Name: NameFull: Park, Hanbit – PersonEntity: Name: NameFull: Kang, Tae Soo – PersonEntity: Name: NameFull: Koh, Jin-Sin – PersonEntity: Name: NameFull: Park, Kyung-Taek – PersonEntity: Name: NameFull: Bang, Duk Won – PersonEntity: Name: NameFull: Goh, Choong-Won – PersonEntity: Name: NameFull: Yoon, Hyuck-Jun – PersonEntity: Name: NameFull: Jo, Sang-Ho IsPartOfRelationships: – BibEntity: Dates: – D: 08 M: 11 Text: Nov2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 01406736 Numbering: – Type: volume Value: 406 – Type: issue Value: 10516 Titles: – TitleFull: Lancet Type: main |
| ResultId | 1 |
