Onyx ONE sub-analysis shows higher cardiac death for P2Y12 inhibitor compared to aspirin following DAPT

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Azeem Latib (New York, USA) spoke to Cardiovascular News about a sub-analysis of the Onyx ONE study. The study randomised 2,000 patients who were high-risk for bleeding in a 1:1 fashion to receive either the durable-polymer Resolute Onyx drug-eluting stent (Medtronic) or the polymer-free BioFreedom DES (Biosensors). Following the procedure both arms were treated with one-month DAPT (aspirin and P2Y12 inhibitor), followed by single antiplatelet therapy thereafter, with follow-up out to one year.

The sub-analysis compared the difference between aspirin and P2Y12 inhibitor following DAPT and found that, although there was “no difference” between the two in terms of combined primary outcome of cardiac death, myocardial infarction and stent thrombosis, the incidence of cardiac death was “higher” in the group that continued with P2Y12 inhibitors.

Latib said that he is “not certain” why the results showed a higher risk of cardiac death in the P2Y12 group, adding that the sub-analysis “suggests that there are some differences which need to be explored further”. He concluded that further data will give a “better insight” into if there are differences and “whether this warrants a randomised trial”.


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