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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  • Muramatsu Takashi
    Department of Cardiology, Fujita Health University Hospital
  • Masuda Shinichiro
    Cardiovascular Research Centre for Advanced Imaging and Core Laboratory (CORRIB), University of Galway
  • Kotoku Nozomi
    Cardiovascular Research Centre for Advanced Imaging and Core Laboratory (CORRIB), University of Galway
  • Kozuma Ken
    Teikyo University Hospital
  • Kawashima Hideyuki
    Teikyo University Hospital
  • Ishibashi Yuki
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Nakazawa Gaku
    Department of Cardiology, Kindai University Faculty of Medicine
  • Takahashi Kuniaki
    Department of Cardiology, Kindai University Faculty of Medicine
  • Okamura Takayuki
    Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Miyazaki Yosuke
    Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Tateishi Hiroki
    Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine Department of Cardiology, Shibata Hospital
  • Nakamura Masato
    Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
  • Kogame Norihiro
    Division of Cardiovascular Medicine, Toho University Ohashi Medical Center Department of Cardiology, Tokyo Rosai Hospital
  • Asano Taku
    Department of Cardiology, St. Luke’s International Hospital
  • Nakatani Shimpei
    Department of Cardiology, JCHO Hoshigaoka Medical Center
  • Morino Yoshihiro
    Department of Cardiology, Iwate Medical University Hospital
  • Katagiri Yuki
    Department of Cardiology, Sapporo Higashi Tokushukai Hospital
  • Ninomiya Kai
    Cardiovascular Research Centre for Advanced Imaging and Core Laboratory (CORRIB), University of Galway
  • Kageyama Shigetaka
    Cardiovascular Research Centre for Advanced Imaging and Core Laboratory (CORRIB), University of Galway
  • Takahashi Hiroshi
    Division of Medical Statistics, Fujita Health University
  • Garg Scot
    Department of Cardiology, Royal Blackburn Hospital
  • Tu Shengxian
    Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University and Shanghai Med-X Engineering Research Center, Shanghai Jiao Tong University
  • Tanabe Kengo
    Division of Cardiology, Mitsui Memorial Hospital
  • Ozaki Yukio
    Department of Cardiology, Fujita Health University Okazaki Medical Center
  • Serruys Patrick W.
    Cardiovascular Research Centre for Advanced Imaging and Core Laboratory (CORRIB), University of Galway
  • Onuma Yoshinobu
    Cardiovascular Research Centre for Advanced Imaging and Core Laboratory (CORRIB), University of Galway Galway University Hospital

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<p>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).</p><p>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.</p><p>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.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 87 (6), 857-865, 2023-05-25

    一般社団法人 日本循環器学会

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