• Fausto Feres, Ricardo A Costa, Deepak L Bhatt, Martin B Leon, Roberto V Botelho, Spencer B King, J Eduardo T de Paula, José A Mangione, Décio Salvadori, Marcos O Gusmão, Hélio Castello, Eduardo Nicolela, Marco A Perin, Fernando S Devito, J Antônio Marin-Neto, and Alexandre Abizaid.
• Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
• Am. Heart J. 2012 Dec 1; 164 (6): 810-6.e3.

BackgroundCurrent recommendations for antithrombotic therapy after drug-eluting stent (DES) implantation include prolonged dual antiplatelet therapy (DAPT) with aspirin and clopidogrel ≥12 months. However, the impact of such a regimen for all patients receiving any DES system remains unclear based on scientific evidence available to date. Also, several other shortcomings have been identified with prolonged DAPT, including bleeding complications, compliance, and cost. The second-generation Endeavor zotarolimus-eluting stent (E-ZES) has demonstrated efficacy and safety, despite short duration DAPT (3 months) in the majority of studies. Still, the safety and clinical impact of short-term DAPT with E-ZES in the real world is yet to be determined.MethodsThe OPTIMIZE trial is a large, prospective, multicenter, randomized (1:1) non-inferiority clinical evaluation of short-term (3 months) vs long-term (12-months) DAPT in patients undergoing E-ZES implantation in daily clinical practice. Overall, 3,120 patients were enrolled at 33 clinical sites in Brazil. The primary composite endpoint is death (any cause), myocardial infarction, cerebral vascular accident, and major bleeding at 12-month clinical follow-up post-index procedure.ConclusionsThe OPTIMIZE clinical trial will determine the clinical implications of DAPT duration with the second generation E-ZES in real-world patients undergoing percutaneous coronary intervention.Copyright © 2012 Mosby, Inc. All rights reserved.

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