著者

Takashi Muramatsu Shinichiro Masuda Nozomi Kotoku Ken Kozuma Hideyuki Kawashima Yuki Ishibashi Gaku Nakazawa Kuniaki Takahashi Takayuki Okamura Yosuke Miyazaki Hiroki Tateishi Masato Nakamura Norihiro Kogame Taku Asano Shimpei Nakatani Yoshihiro Morino Yuki Katagiri Kai Ninomiya Shigetaka Kageyama Hiroshi Takahashi Scot Garg Shengxian Tu Kengo Tanabe Yukio Ozaki Patrick W. Serruys Yoshinobu Onuma

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0051, (Released:2023-03-11)

参考文献数

36

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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 <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.