Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Late Breaking Clinical Trials (JCS 2023)
Prasugrel Monotherapy After Percutaneous Coronary Intervention With Biodegradable-Polymer Platinum-Chromium Everolimus Eluting Stent for Japanese Patients With Chronic Coronary Syndrome (ASET-JAPAN)
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
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Keywords: Antiplatelet monotherapy, Coronary artery disease, Drug-eluting stent, Prasugrel, Percutaneous coronary intervention
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2023 Volume 87 Issue 6 Pages 857-865

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Abstract

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.

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© 2023, THE JAPANESE CIRCULATION SOCIETY

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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