Percutaneous Coronary Intervention Followed by Antiplatelet Monotherapy in the Setting of Acute Coronary Syndromes

Inclusion Criteria:

Subjects must meet all the criteria below:

1. Age >=18 years;

2. Clinical presentation compatible with acute coronary syndrome with onset < 24 hoursbefore admission;

3. Successful percutaneous coronary intervention(s) of all target lesions (culprit andnon-culprit) with new-generation drug-eluting stents;

4. Length of stay in hospital at randomization < 96 hours;

5. Subjects will be informed about the nature of the study and must agree to comply andgive an informed consent in writing using a form approved in advance by the localEthics Committee.

Exclusion Criteria:

Subjects meeting any of the following criteria will be excluded:

1. Acute coronary syndrome on index admission treated in a conservative way or byunsuccessful percutaneous intervention or surgically;

2. Presence of residual lesions which are likely to require future treatment in thenext 12 months;

3. Fibrinolytic therapy < 24 hour before randomization;

4. Need of oral anticoagulation with warfarin or new anticoagulants;

5. Chronic bleeding diathesis;

6. Active or recent major bleeding (in-hospital);

7. Prior intracranial hemorrhage;

8. Ischemic cerebrovascular accident < 30 days;

9. Presence of brain arteriovenous malformation;

10. Index event of non-atherothrombotic etiology (i.e., stent thrombosis, coronaryembolism, spontaneous coronary artery dissection, myocardial ischemia due tosupply/demand imbalance);

11. Potential or scheduled cardiac or non-cardiac surgery in the next 12 months;

12. Platelet count < 100,000 cells/mm3 or > 700,000 cells/mm3;

13. Total white blood count < 3,000 cells/mm3;

14. Suspected or documented active liver disease (including laboratory evidence ofhepatitis B or C);

15. Receiver of heart transplant;

16. Known allergies or intolerance of acetylsalicylic acid, clopidogrel, ticlopidine,ticagrelor, prasugrel, heparin or antiproliferative agents from the limus-family ofdrugs;

17. Subject with life expectation lower than 1 year;

18. Any significant medical condition that, in the investigator's opinion, couldinterfere with the ideal participation of the subject in the study;

19. Participation in other study in the past 12 months, unless a direct benefit to thesubject can be expected.

20. Impossibility of being treated with dual antiplatelet therapy for 12 months, basedon investigator judgement.