Lancet: The "dose reduction strategy" of double antiplate plate plate therapy significantly improved the postoperative prognosis of PCI in patients with acute coronary syndrome.

Patients with acute coronary syndrome treated with coronary artery intervention (PCI) are recommended for up to one year with double antiplate plate plate treatment based on P2Y12 inhibitors.
the greatest benefit of this P2Y12 inhibitor is in the early stages of medication, and the risk of haemorrhage increases as the duration of the drug increases.
but the degradation of antiplate plateroid therapy may provide the best balance between isoemia and bleeding.
study aims to study the safety and effective-based dose reduction therapy.
HOST-REDUCE-POLYTECH-ACS trial was a multi-center, open-label, non-inefficient randomized trial conducted in 35 hospitals in South Korea, which recruited patients with PCI-compliant acute coronary syndrome, randomly assigned to a dose reduction group or a regular group, 1:1.
month after treatment with 10 mg Pragre and aspirin 100 mg (1/day), the dose reduction group changed to 5 mg and the regular group remained unchanged.
the main endpoint of the disease is a year of net adverse clinical events (all due to death, non-fatal myocardial infarction, stent thrombosis, repeated vascular reconstruction, stroke, and level 2 bleeding).
the absolute non-shoddy boundary value of the main endpoint of the property is 2.5%.
secondary endpoints are therapeutic prognosis (cardioentipathic death, myocardial infarction, stent thrombosis and ischemic stroke) and safety prognosis (level 2 bleeding).
September 30, 2014 - December 18, 2018, a total of 3,429 patients were screened, of whom 2,338 were randomly assigned to the dose reduction group (n-1170) or the regular group (n-1168).
82 patients (7.2%) in the dose reduction group had the primary endpoint, while 116 patients in the conventional group (10.1%, absolute risk difference -2.9%, p.lt;0.0001; risk ratio 0.70,95% CI 0.52-0.92;p-lt;0.012).
there was no increase in ishemia risk in the dose reduction group (0.76 (0.40-1.45; p-0.40) compared to the conventional group, and the risk of bleeding events was significantly reduced (0.48 (0.32-0.73; p-0.0007).
In patients with acute coronary syndrome in Asia who were receiving PCI, a Pragray-based dose reduction programme in the first month of PCI reduced the net clinical prognosis risk up to 1 year, mainly with reduced bleeding and no increase in ischemia events.
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