Clopidogrel vs Aspirin According to Diabetes Mellitus: A Prespecified Analysis of the SMART-CHOICE 3 Trial.

JACC Cardiovasc IntervJul 16, 2026 (epub)
Clinical ResearchCardiology

Sang Yoon Lee, Donghyeon Joo, Joo Myung Lee et al.

✦ AI-curated · Sources linked

In 30 seconds

This prespecified analysis of the SMART-CHOICE 3 trial evaluated the efficacy and safety of clopidogrel versus aspirin in 5,506 patients post-PCI, focusing on those with diabetes mellitus (DM). The study found that clopidogrel significantly reduced the risk of major adverse cardiac and cerebrovascular events (MACCE) in DM patients compared to aspirin, with rates of 4.5% versus 9.1% (HR: 0.57, P = 0.008).

Key findings

  • Diabetes mellitus patients had a higher risk of MACCE at 6.8% compared to 4.7% in non-DM patients (HR: 1.44, P = 0.008).
  • Clopidogrel reduced MACCE risk in DM patients to 4.5% versus 9.1% for aspirin (HR: 0.57, P = 0.008).
  • Bleeding risk was similar between clopidogrel and aspirin in DM patients at 2.9% for both groups (HR: 1.06, P = 0.855).

Why it matters

The findings suggest that clopidogrel may be a more effective monotherapy than aspirin for reducing serious cardiovascular events in diabetic patients after PCI, which could influence treatment decisions in this high-risk population.

Source

PubMed · PMID 42461194

Published in JACC Cardiovasc Interv. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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