Inclusion Criteria:
Any indication for PCI-S in patients deemed at high risk for bleeding and candidates for 1 month DAPT. This includes candidates with stable angina, silent ischemia, ACS (STEMI and non-STEMI), non-native lesions and in-stent restenosis. Patients must provide written informed consent.
Reasons of unsuitability for > 1 month dual antiplatelet treatment must include one or MORE of the following:
- Adjunctive oral anticoagulation treatment planned to continue after PCI
- Age ≥ 75 years old
- Baseline Hgb <11 g/dl (or anemia requiring transfusion during the 4 weeks prior to enrollment)
- Any prior intracerebral bleed
- Any stroke in the last 12 months
- Hospital admission for bleeding during the prior 12 months
- Non skin cancer diagnosed or treated < 3 years
- Planned daily NSAID (other than aspirin) or steroids for >30 days after PCI
- Planned surgery that would require interruption of DAPT (within next 12 months)
- Renal failure defined as: Creatinine clearance <40 ml/min
- Thrombocytopenia (PLT <100,000/mm3)
- Severe chronic liver disease defined as: patients who have developed any of the following: variceal hemorrhage, ascites, hepatic encephalopathy or jaundice
- Expected non-compliance to prolonged DAPT for other medical reasons
Exclusion Criteria:
- Pregnant and breastfeeding women
- Patients expected not to comply with 30 days DAPT
- Patients requiring a planned staged PCI procedure more than one week after the index procedure
- Procedure planned to require non-study stents, or stand-alone POBA or stand-alone atherectomy
- Active bleeding at the time of inclusion
- Reference vessel diameter <2.25 ~ >4.0mm
- Cardiogenic shock
- Compliance with long-term single anti-platelet therapy unlikely
- A known hypersensitivity or contraindication to aspirin, clopidogrel or other P2Y12 inhibitor (if applicable), stainless steel, zinc, Biolimus A9 or a sensitivity to contrast media, which cannot be adequately pre-medicated
- PCI during the previous 12 months for a lesion other than the target lesion of the index procedure
- Participation in another clinical trial (12 months after index procedure)
- Patients with a life expectancy of < 1 year