Clopidogrel Proves More Effective Than Aspirin Post-PCI, Study Finds
Seoul, Monday, 31 March 2025.
A study by Samsung Medical Center reveals clopidogrel reduces death, heart attacks, and strokes more effectively than aspirin in post-PCI patients, without increased bleeding risk.
Groundbreaking Trial Results
The SMART-CHOICE 3 trial, involving 5,506 patients across 26 South Korean medical centers, has demonstrated compelling evidence for the superiority of clopidogrel over aspirin in high-risk patients [1]. After a median follow-up period of 2.3 years, patients receiving clopidogrel showed a 33.333% reduction in adverse events compared to those on aspirin therapy [1]. The study specifically focused on patients with prior heart attacks, medication-treated diabetes, or complex coronary artery lesions [1][2].
Clinical Implications
Most notably, the research revealed that patients taking clopidogrel experienced significantly fewer heart attacks, with an incidence rate of just 1% compared to 2.2% in the aspirin group [1]. Dr. Joo-Yong Hahn, the lead investigator from Samsung Medical Center, emphasized that these improved outcomes were achieved without an increased risk of major bleeding events, a crucial consideration in antiplatelet therapy [1][3]. The findings were presented at the ACC.25 conference in Chicago on March 30, 2025, and simultaneously published in the Lancet [1].
Future Impact on Patient Care
The study’s results could significantly influence clinical practice guidelines for post-PCI patient care [2]. This research particularly benefits high-risk patients requiring long-term antiplatelet therapy after completing standard dual antiplatelet treatment [3]. The findings suggest that clopidogrel monotherapy represents an optimal anti-thrombotic strategy for patients with contemporary drug-eluting stents [3].