Study Comparing Short Prasugrel-Based Dual Antiplatelet Therapy Followed by Prasugrel Alone Versus Standard Dual Antiplatelet Therapy in Heart Attack Patients with OCT- or Angio-Guided Complete Revascularization

What this Trial Is About

This research focuses on patients who have experienced ST segment elevation myocardial infarction STEMI and require percutaneous coronary intervention PCI. The study compares two approaches a shorter duration of dual antiplatelet therapy DAPT with Prasugrel followed by Prasugrel monotherapy versus the standard one-year DAPT regimen. Additionally, in patients with multivessel disease MVD, the trial evaluates the effectiveness and safety of complete revascularization guided by either Optical Coherence Tomography OCT or angiography. Participants receive a loading dose of aspirin and Prasugrel at the time of PCI, treating the culprit lesion first. For those with MVD, non-culprit lesions are treated in staged procedures within 15 days. Following 30 to 45 days after the initial procedure, eligible patients are randomized to either continue short DAPT with Prasugrel monotherapy or follow the standard 12-month DAPT. Complete revascularization in MVD patients is further randomized to OCT-guided or angiography-guided strategies. Participants will be followed clinically for 35 months after randomization to monitor outcomes, with key assessments at 11 and 35 months. Researchers will measure safety and efficacy endpoints, including major adverse cardiac and cerebrovascular events and bleeding events. The study includes detailed monitoring of treatment adherence, successful revascularization, and clinical events to evaluate the comparative benefits of the treatment strategies.

Comparison Of Reduced DAPT Followed by P2Y12 Inhibitor Monotherapy With Prasugrel vs stAndard Regimen in STEMI Patients