July 16, 2026 · JACC. Cardiovascular interventions · DOI: 10.1016/j.jcin.2026.05.013

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

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The authors aimed to compare the efficacy and safety of clopidogrel versus aspirin monotherapy in patients with diabetes mellitus (DM) following percutaneous coronary intervention (PCI). Their analysis of the SMART-CHOICE 3 trial found that clopidogrel significantly reduced the risk of major adverse cardiac and cerebrovascular events compared to aspirin in DM patients, without increasing bleeding risk. Additionally, the study indicated no significant interaction between the presence of DM and the effectiveness of the antiplatelet therapies regarding these outcomes.

Sang Yoon Lee, Donghyeon Joo, Joo Myung Lee, Yong Hwan Park, Jong-Young Lee, Jin-Ok Jeong, Chan Joon Kim, Han Cheol Lee, Kiyuk Chang, Mahn-Won Park, Jang-Whan Bae, Joon-Hyung Doh, Byung Ryul Cho, Hee-Yeol Kim, Weon Kim, Ung Kim, Seung-Woon Rha, Young Joon Hong, Hyun-Jong Lee, Sung Gyun Ahn, Doo-Il Kim, Jang Hyun Cho, Sung Ho Her, Doo Soo Jeon, Seung Hwan Han, Jin-Bae Lee, Cheol Whan Lee, Danbee Kang, Ki Hong Choi, Taek Kyu Park, Jeong Hoon Yang, Soo-Youn Lee, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Young Bin Song, Joo-Yong Hahn, Kyeong Ho Yun, SMART-CHOICE 3 Investigators

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