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

Summary

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. Herein, we plan the HOST-coronary intervention with next-generation drug-eluting stent platforms and abbreviated dual antiplatelet therapy (HOST-IDEA) trial to compare single antiplatelet therapy (SAPT) after 3-month DAPT with 12-month DAPT in all-comers undergoing coronary intervention with third-generation DES with the thinnest struts. P2Y12 inhibitor 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. Net adverse clinical events (NACEs), a composite of cardiac death, target vessel related myocardial infarction, clinically-drivent target lesion revascularization, definite or probable stent thrombosis and major bleeding is a primary endpoint for evaluating safety and efficacy of the difference of DAPT duration. 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 secondary ischemic outcome. 1-year major bleeding events classified as BARC type 3 or 5 bleeding events will be identified as a secondary bleeding outcome. 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.

Timeline

Start

2016-01-18

Primary completion

2021-08-14

Completion

2022-08-14

Publications

• Han JK, Hwang D, Yang S, Park SH, Kang J, Yang HM, Park KW, Kang HJ, Koo BK, Hur SH, Kim W, Kim SY, Park SH, Han SH, Kim SH, Shin S, Park K, Lee SJ, Kim JW, Lee N, Kim HS. Abbreviated dual antiplatelet therapy after percutaneous coronary intervention with ultrathin-strut drug-eluting stents in South Korea: 3-year outcomes of the multicentre, randomised HOST-IDEA trial. EClinicalMedicine. 2025 Dec 18;91:103698. doi: 10.1016/j.eclinm.2025.103698. eCollection 2026 Jan.
• Han JK, Lee K, Park SH, Yang S, Hwang D, Kang J, Yang HM, Park KW, Kang HJ, Koo BK, Hur SH, Kim W, Park SH, Han SH, Kim SH, Kim YH, Lee N, Lee SJ, Shin S, Kim HS. Short-Term DAPT After Complex PCI With Third-Generation DES: A Post Hoc Analysis of the HOST-IDEA Trial. Circ Cardiovasc Interv. 2025 May;18(5):e014623. doi: 10.1161/CIRCINTERVENTIONS.124.014623. Epub 2025 Mar 31.
• Han JK, Yang S, Hwang D, Park SH, Kang J, Yang HM, Park KW, Kang HJ, Koo BK, Cho JM, Cho J, Bang DW, Lee JH, Lee HC, Kim KJ, Chun WJ, Seo WW, Park WJ, Park SM, Kim JW, Kim HS. Biodegradable Polymer Versus Polymer-Free Ultrathin Sirolimus-Eluting Stents: Analysis of the Stent Arm Registry From the HOST-IDEA Randomized Trial. Circ Cardiovasc Interv. 2024 Jul;17(7):e013585. doi: 10.1161/CIRCINTERVENTIONS.123.013585. Epub 2024 May 24.
• Han JK, Hwang D, Yang S, Park SH, Kang J, Yang HM, Park KW, Kang HJ, Koo BK, Hur SH, Kim W, Kim SY, Park SH, Han SH, Kim SH, Shin S, Kim YH, Park K, Lee N, Lee SJ, Kim JW, Kim HS. Comparison of 3- to 6-Month Versus 12-Month Dual Antiplatelet Therapy After Coronary Intervention Using the Contemporary Drug-Eluting Stents With Ultrathin Struts: The HOST-IDEA Randomized Clinical Trial. Circulation. 2023 May 2;147(18):1358-1368. doi: 10.1161/CIRCULATIONAHA.123.064264. Epub 2023 Mar 5.
• Kim CH, Han JK, Yang HM, Park KW, Lee HY, Kang HJ, Koo BK, Lee N, Cha TJ, Yang TH, Jeong MH, Yoon MH, Lee SU, Lee SJ, Kim JW, Cho JM, Han KR, Pyun WB, Kim HS. Study protocol for a randomised controlled trial: harmonising 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. BMJ Open. 2017 Oct 11;7(10):e016617. doi: 10.1136/bmjopen-2017-016617.

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Indications