[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-608584-105":59,"doc-detail-608584-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","clopidogrel-or-dual-antiplatelet-therapy-in-high-ischemic-risk-patients","Clopidogrel or Dual Antiplatelet Therapy in High-Ischemic-Risk Patients","","This open-label, noninferiority trial in South Korea tested whether clopidogrel monotherapy is noninferior to extended dual antiplatelet therapy (DAPT) with clopidogrel plus aspirin beyond 12 months after drug-eluting stent implantation in patients with high ischemic risk. Net adverse clinical events at 24 months were analyzed as a composite including death, MI, stent thrombosis, stroke, and BARC bleeding. Primary results showed noninferiority, while key secondary outcomes indicated fewer ischemic events with monotherapy and less clinically relevant bleeding than DAPT.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/clopidogrel-or-dual-antiplatelet-therapy-in-high-ischemic-risk-patients/608584/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/clopidogrel-or-dual-antiplatelet-therapy-in-high-ischemic-risk-patients/608584.png","ImageObject",300,407,{"name":92,"@type":93},"Riley West","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-10-17",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main comparison in the trial?","Question",{"text":112,"@type":113},"The study compared clopidogrel monotherapy with extended dual antiplatelet therapy (clopidogrel plus aspirin) beyond 12 months after drug-eluting stent implantation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were outcomes measured at 24 months?",{"text":117,"@type":113},"The primary endpoint was net adverse clinical events, a composite of death from any cause, myocardial infarction, stent thrombosis, stroke, and BARC type 2, 3, or 5 bleeding.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the results show about ischemic and bleeding events?",{"text":121,"@type":113},"At 24 months, the primary net adverse clinical event rate was similar between groups, meeting noninferiority. Key secondary ischemic events occurred less often with clopidogrel monotherapy, and key secondary bleeding occurred less often with monotherapy than with extended DAPT.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},608584,1792604030,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099523885074,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","The new e ngla nd jou r na l of m e dicine  \nOriginal Article  \nClopidogrel or Dual Antiplatelet Therapy in High-Ischemic-Risk Patients  \nS.-J. Lee,1 Y.-J. Lee,1 K. Lee,2 D.-K. Cho,3 Y.-H. Cho,4 S.G. Ahn,5 K. H. Yun,6 J.-Y. Jang,7 S. Kim,8 Y. H. Kim,9 Y. H. Park,10 S.U. Kwon,11 S.-H. Hur,12 T.S. Kang,13 E.-S. Shin,14 J. B. Lee,15 K.-H. Jeon,16 U. Kim,17 W. H. Kim,18 B.-K. Hong,19 S.-H. Lee,1 S.-J. Hong,1 C.-M. Ahn,1 J.-S. Kim,1 Y.-G. Ko,1 D. Choi,1 M.-K. Hong,1 Y. Jang,1 and B.-K. Kim,1 for the A-CLOSE investigators*  \nA BST RACT  \nBACKGROUND  \nThe effect of clopidogrel monotherapy as compared with extended dual antiplatelet therapy (DAPT) with clopidogrel and aspirin beyond 12 months after implantation ofa drug-eluting stent remains uncertain in patients at high risk for recurrent ischemic events.  \nMETHODS  \nIn this open-label noninferiority trial conducted in South Korea, we enrolled patients with high-risk clinical or lesion characteristics in whom a drug-eluting stent had been implanted 12 months earlier and randomly assigned them, in a 1:1 ratio, to receive clopidogrel monotherapy or extended DAPT (clopidogrel plus aspirin). The primary end point was net adverse clinical events, a composite of death from any cause, myocardial infarction, stent thrombosis, stroke, or Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding at 24 months (noninferiority margin, 2.3 percentage points). Key secondary ischemic and bleeding endpoints were tested in a prespecified hierarchical order.  \nRESULTS  \nOf the 3203 patients who underwent randomization, 1601 were assigned to receive clopidogrel monotherapy and 1602 to receive extended DAPT. Over the course of 24 months, a primary end-point event occurred in 80 patients (5.0%) in the monotherapy group and in 81 (5.1%) in the DAPT group (risk difference, −0.1 percentage points; 90% confidence interval [CI], −1.3 to 1.2; P = 0.001 for noninferiority). Death from any cause, myocardial infarction, stent thrombosis, or stroke (the key secondary ischemic end point) occurred in 60 patients (3.7%) in the monotherapy group and in 26 (1.6%) in the DAPT group (hazard ratio, 2.33; 95% CI, 1.47 to 3.69; P\u003C0.001). BARC type 2, 3, or 5 bleeding (the key secondary bleeding endpoint) occurred in 28 patients (1.8%) in the monotherapy group and in 65 (4.1%) in the DAPT group (hazard ratio, 0.43; 95% CI, 0.27 to 0.67; P\u003C0.001). The incidence of serious adverse events was similar in the two groups.  \nThe authors’ full names, academic degrees, and affiliations are listed at the end of the article. Byeong-Keuk Kim can be contacted at kimbk@yuhs. ac or at the Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, South Korea.  \n*A list of the A-CLOSE investigators is provided in the Supplementary Appendix, available [at NEJM.org](at NEJM.org).  \nSeung-Jun Lee and Yong-Joon Lee contributed equally to this article.  \nThis article was published on August 29, 2026, [at NEJM.org](at NEJM.org).  \nDOI: 10.1056/NEJMoa2608533  \nCopyright © 2026 Massachusetts Medical Society.  \nCONCLUSIONS  \nAmong patients at high risk for ischemic events 12 months after drug-eluting stent implantation, clopidogrel monotherapy was noninferior to extended DAPT with respect to net adverse clinical events at 24 months. (Funded by Chong Kun Dang and Samjin; A-CLOSE [ClinicalTrials.gov](ClinicalTrials.gov) number, NCT03947229.)  \nn eng l j med [nej m.org](nej m.org)  \nThe New England Journal of Medicine is produced by NEJM Group, a division of the Massachusetts Medical Society.  \n1  \nThe new e ngla nd jou r na l of m e dicine  \nP 2Y12 receptor inhibitors, particu  \nlarly clopidogrel, remain central to anti  \nplatelet therapy after percutaneous coronary intervention (PCI) with drug-eluting stents.1-4 Current guidelines recommend 6 to 12 months of dual antiplatelet therapy (DAPT) followed by long-term single antiplatelet therapy with either aspirin or clopidogre","cbCaits6VZeMqHSm","https://ap.wps.com/l/cbCaits6VZeMqHSm","pdf",6968665,196,"English","# Background\n# Methods\n## Trial Design and Oversight\n# Results\n# Conclusions","[{\"question\":\"What was the main comparison in the trial?\",\"answer\":\"The study compared clopidogrel monotherapy with extended dual antiplatelet therapy (clopidogrel plus aspirin) beyond 12 months after drug-eluting stent implantation.\"},{\"question\":\"How were outcomes measured at 24 months?\",\"answer\":\"The primary endpoint was net adverse clinical events, a composite of death from any cause, myocardial infarction, stent thrombosis, stroke, and BARC type 2, 3, or 5 bleeding.\"},{\"question\":\"What did the results show about ischemic and bleeding events?\",\"answer\":\"At 24 months, the primary net adverse clinical event rate was similar between groups, meeting noninferiority. Key secondary ischemic events occurred less often with clopidogrel monotherapy, and key secondary bleeding occurred less often with monotherapy than with extended DAPT.\"}]","Clopidogrel or Dual Antiplatelet Therapy in High-Ischemic-Risk Patients | PDF",1792272732,494]