<div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="369895825" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{12}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">Aspirin<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">remains</span><span> </span><span class="NormalTextRun SCXW249595376 BCX0">an important component</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>of early antiplatelet treatment after an ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI), according to<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">the<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">PREMIUM trial<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">findings</span><span class="NormalTextRun SCXW249595376 BCX0">.</span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" lang="EN-US" paraid="1572175157" paraeid="{4fad76b8-789e-4e9c-a28d-902528673de4}{80}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">The</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>trial, presented<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">during</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>a</span><span> </span><span class="NormalTextRun SCXW249595376 BCX0">Hot Line session</span><span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">on Saturday at the European Society of Cardiology (ESC) Congress 2026 in Munich, Germany,<span> </span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">by principal investigator Dr</span><span class="NormalTextRun SCXW249595376 BCX0">.</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>Gaku Nakazawa of<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW249595376 BCX0">Kindai</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>University in Osaka, Japan, randomized 2,280 patients at 69 centers in Japan to prasugrel monotherapy or dual antiplatelet therapy (DAPT) with aspirin plus prasugrel.</span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="5318497" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{16}"><span class="NormalTextRun SCXW249595376 BCX0">At 12 months, the primary endpoint of all-cause death, myocardial infarction or stroke occurred in 11.0% of patients receiving prasugrel monotherapy compared with 8.5% receiving DAPT (hazard ratio [HR] 1.34; 95% confidence interval [CI] 1.02–1.75; p=0.40 for noninferiority).</span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="150421245" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{18}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">Primary </span><span class="NormalTextRun SCXW249595376 BCX0">e</span><span class="NormalTextRun SCXW249595376 BCX0">ndpoint </span><span class="NormalTextRun SCXW249595376 BCX0">m</span><span class="NormalTextRun SCXW249595376 BCX0">issed</span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="343954957" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{20}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">“These findings do not support prasugrel monotherapy at the time of primary PCI for STEMI,” concluded Dr</span><span class="NormalTextRun SCXW249595376 BCX0">.</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>Nakazawa</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>in an ESC press release on Saturday</span><span class="NormalTextRun SCXW249595376 BCX0">.</span><span> </span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" lang="EN-US" paraid="1984882846" paraeid="{693e8b51-c231-4696-a773-f083aec094a5}{199}"><span class="NormalTextRun SCXW249595376 BCX0">“It appears that DAPT is needed for at least the first month but the optimum duration of DAPT remains to be determined.”</span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="2051904737" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{22}"><span class="NormalTextRun SCXW249595376 BCX0">The investigator-initiated, open-label trial, supported by Boston Scientific</span><span class="NormalTextRun SCXW249595376 BCX0">, found that Bleeding Academic Research Consortium type 3 or 5 bleeding occurred in 5.6% of patients assigned to prasugrel monotherapy and 8.4% of those receiving DAPT (HR 0.66; 95% CI 0.47–0.91).</span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="1876907203" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{24}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">However, because noninferiority was not achieved for the primary endpoint, the major secondary bleeding endpoint was not<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">analyzed</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>statistically. </span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="1401121832" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{26}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">Stent-related complications were similar between groups, while non-stent-related events, including non-target lesion<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">revascularization</span><span class="NormalTextRun SCXW249595376 BCX0">, were more frequent with prasugrel alone.</span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="179870000" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{28}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">“Previous<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">randomized</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>trials have demonstrated the safety of 1−3 months of DAPT followed by P2Y12 inhibitor monotherapy compared with 12 months of DAPT</span><span class="NormalTextRun SCXW249595376 BCX0">,” said Dr<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">Nakazawa</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>during the press release</span><span class="NormalTextRun SCXW249595376 BCX0">.</span><span> </span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" lang="EN-US" paraid="1767119146" paraeid="{3413a4f5-9695-4f35-96f2-c344fd7a7136}{197}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">“</span><span class="NormalTextRun SCXW249595376 BCX0">However, the safety of initiating prasugrel as monotherapy at the time of contemporary imaging-guided PCI compared with standard 12-month DAPT remains unknown.”</span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="870399995" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{30}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">Current </span><span class="NormalTextRun SCXW249595376 BCX0">t</span><span class="NormalTextRun SCXW249595376 BCX0">reatment </span><span class="NormalTextRun SCXW249595376 BCX0">g</span><span class="NormalTextRun SCXW249595376 BCX0">uidance</span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="940083156" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{32}"><span class="NormalTextRun SCXW249595376 BCX0">Current ESC guidance recommends 12 months of DAPT with aspirin and a potent P2Y12 inhibitor such as prasugrel or ticagrelor after PCI for STEMI, although treatment can be shortened in selected clinical circumstances.</span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="750810197" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{34}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">Participants in PREMIUM had STEMI<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">requiring</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>primary PCI with current-generation platinum-chromium everolimus-eluting stents and were<span> </span></span><span class="NormalTextRun SCXW249595376 BCX0">randomized</span><span class="NormalTextRun SCXW249595376 BCX0"><span> </span>1:1 before PCI to prasugrel monotherapy or aspirin plus prasugrel. Patients with atrial fibrillation or other indications for oral anticoagulation were excluded.</span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="2092122505" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{36}"><span class="NormalTextRun SCXW249595376 BCX0">Patients assigned to DAPT who were at high bleeding risk could switch to prasugrel monotherapy after three months at the clinician’s discretion. The randomized population had a mean age of around 69 years, and 23% were women.</span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" paraid="716391590" paraeid="{9b7e3754-ab48-49dd-bf60-b911f85c98da}{38}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW249595376 BCX0"><span class="NormalTextRun SCXW249595376 BCX0">Image Credit: </span><span class="NormalTextRun SCXW249595376 BCX0">European Society of Cardiology 2026.</span></span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"335551550":6,"335551620":6,"335559739":100}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW249595376 BCX0"> <p class="Paragraph SCXW249595376 BCX0" lang="EN-US" paraid="1608604786" paraeid="{a1a1a014-e84b-4a4d-a062-a6c6cc0dae07}{27}"><strong><span class="NormalTextRun SCXW249595376 BCX0">Image Caption: Entrance to the conference hall at the European Society of Cardiology (ESC) Congress 2026 in Munich, Germany.</span><span class="EOP Selected SCXW249595376 BCX0" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":6,"335551620":6,"335559685":0,"335559737":0,"335559738":0,"335559739":160,"335559740":259}"> </span></strong></p> </div>