OPT-CAD Score GUIded Dual ANtiplatelet De-esCalation Time

Summary

Monotherapy with a P2Y12 inhibitor after a minimum period of DAPT following percutaneous coronary intervention (PCI) is an emerging de-escalation antiplatelet strategy in recent years. However, the optimal timing for de-escalating DAPT in ACS patients undergoing PCI remains debated. The OPT-CAD score is a risk stratification tool derived from Chinese patients which has been demonstrated superior predictive capabilities for ischemic events and all-cause mortality than the GRACE score. Therefore, we hypothesize that the OPT-CAD score can be used to guide the timing of the DAPT de-escalation strategy to monotherapy with P2Y12 inhibitors for ACS patients, that is, low-risk patients could be de-escalated after 1 month, while high-risk patients could be de-escalated after 3 months, so as to achieve individualized antithrombotic therapy and maximize patient benefit.

Eligibility

Inclusion Criteria:

1. Adult patients with ages of 18-80 years;
2. Patients with clinically diagnosed ACS who have undergone at least one DES implantation;
3. Individuals capable of completing the OPT-CAD scoring calculation;
4. Researchers assessing that participants can tolerate at least a 12-month duration of DAPT therapy;
5. Written informed consent provided.

Exclusion Criteria:

1. Left main coronary artery lesion PCI;
2. Allergy to study drugs such as aspirin, clopidogrel, or ticagrelor;
3. Meeting 1 major or 2 minor criteria for high bleeding risk according to the ARC-HBR criteria;
4. Anticipated need for revascularization or surgical intervention within 12 months;
5. Severe ischemia or hemorrhage events during the current hospitalization;
6. Life expectancy of other serious diseases is less than 1 year;
7. Pregnant or women of childbearing age who intend to conceive within 1 year;
8. Participation in other clinical trials while still under observation;
9. Researchers considering ineligibility for enrollment.

Conditions2

Browse More Trials