A landmark 10-year follow-up of the HOST-EXAM trial published in The Lancet challenges a century-old assumption: aspirin may no longer be the default for lifelong secondary prevention after PCI.

Clopidogrel demonstrated a sustained reduction in ischemic and bleeding events (HR 0.86, p=0.005), with benefits that accumulated over time—yet without a mortality difference.

The implication is subtle but profound: we may be witnessing the quiet reshaping of antiplatelet strategy.

In cardiology, tradition often lingers—but data, eventually, prevails.