Last updated on September 2016

Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis - Coronary Intervention With Next Generation Drug-Eluting Stent Platforms and Abbreviated Dual Antiplatelet Therapy (HOST-IDEA) Trial


Brief description of study

We had little experience in coronary intervention with recently introduced newer drug-eluting stent (DES) platforms, despite great anticipation, and optimal duration of dual antiplatelet therapy (DAPT) for these stent systems still needs to be established. With a 2x2 factorial design for patients of stable angina or silent ischemia, the investigators formulate a head-to-head randomized comparison between sirolimus-eluting Orsiro stent with biodegradable polymer and polymer-free stent platform with the same antiproliferative agent, Coroflex ISAR stent system. At the same time, clopidogrel treatment is added to aspirin during the 3-months period after the stenting, and this abbreviated duration of DAPT will be compared with conventional 1-year mandatory DAPT regimen in a 1:1 randomized stratification. 1-year target lesion failure (TLF) as a composite of cardiac death, target vessel related myocardial infarction and clinically driven target lesion revascularization will be identified as a primary efficacy outcome. And in addition to TLF, definite or probable stent thrombosis and major bleeding events will also be counted as a composite outcome of net adverse clinical events (NACEs) to comprehensively adjudicate the efficacy and safety outcomes according to the difference of DAPT duration. With this trial, you will be able to get clear insight on the behavior of newer DES platforms. Reference data for the shortened mandatory DAPT regimen will also be delineated in the selected patients, and it might be helpful to those who need it.

Detailed Study Description

Every antiplatelet-naïve patient undergoing an elective procedure will be given 300 mg aspirin and loading dose of one of P2Y12 receptor inhibitors (e.g., 600 mg clopidogrel, 60 mg prasugrel or 180 mg ticagrelor) preferably ≥2 hours before the intervention. These loading doses can be waived for chronic antiplatelet users, and prasugrel or ticagrelor can be used instead of clopidogrel. Choice for P2Y12 inhibitors will be left to responsible physicians' discretion, and this decision will be based on the patient/lesional characteristics.

Clinical Study Identifier: NCT02601157

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Tae-Hyun Yang, M.D., PhD

Busan Paik Hospital
Busan, Korea, Republic of
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Tae-Joon Cha, M.D., PhD

Kosin University Gospel Hospital
Busan, Korea, Republic of
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Seung Jin Lee, M.D., PhD

SoonChunHyang University Cheonan Hospital
Cheonan, Korea, Republic of
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Myung-Ho Jeong, M.D., PhD

Chonnam National University Hospital
Gwangju, Korea, Republic of
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Seung Uk Lee, M.D., PhD

Gwangju Christian Hospital
Gwangju, Korea, Republic of
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Namho Lee, M.D., PhD

Kangnam Sacred Heart Hospital
Seoul, Korea, Republic of
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Jin Won Kim, M.D., PhD

Korea University Guro Hospital
Seoul, Korea, Republic of
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Jin-Man Cho, M.D., PhD

Kyung Hee University Hospital at Gangdong
Seoul, Korea, Republic of
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Hyo-Soo Kim, M.D., PhD

Seoul National University Hospital
Seoul, Korea, Republic of
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Myeong-Ho Yoon, M.D., PhD

Ajou University Hospital
Suwon, Korea, Republic of
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Eun-Seok Shin, M.D., PhD

Ulsan University Hospital
Ulsan, Korea, Republic of
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