OCT or Angiography Guided De-escalation of DAPT

Inclusion criteria

• 18 ~ 85 years old adult patients;
• Patients diagnosed with STEMI and undergoing PCI.
• Patients able and willing to give written informed consent and to comply with the requirements of this study protocol.

Exclusion criteria

• Prior history of intracranial hemorrhage or ischemic stroke during the past 6 months；
• Allergy to aspirin or clopidogrel or ticagrelor;
• Occurrence of major adverse cardiovascular event (MACE) within 30 days after undergoing PCI;
• Platelet count < 50 × 109/L;
• Major bleeding during the past 12 months;
• Any form of oral, long-term anticoagulation therapy;
• Pregnancy or lactation;
• Suspected aortic dissection;
• Coronary CT-negative patients;
• Life expectancy <1 year;
• Uncontrolled hypertension, systolic blood pressure (SBP) ≥180 mmHg, and/or diastolic blood pressure (DBP) ≥110 mmHg;
• Comorbid conditions included the presence of any of the following: cardiogenic shock, chronic congestive heart failure with NYHA classes III or IV, left ventricular ejection fraction (LVEF) < 35% at transthoracic echocardiography, hypotension with SBP < 90mmHg and/or DBP < 60mmHg, severe arrhythmia (including high-degree AV block, sick sinus syndrome, sustained ventricular tachycardia), severe pulmonary insufficiency, pulmonary embolism, hepatic insufficiency due to non-cardiac causes (ALT or AST more than three times the upper limit of the institution's normal reference ranges), cirrhosis, severe renal failure (eGFR < 30ml/min/1.73m2);
• Surgery plan within 30 days;
• Psychiatric abnormalities or alcohol dependence;
• Patients who are participating in other clinical trials;
• Unable to tolerate 1 month of DAPT;
• Angiographic triple vessel disease coronary disease;
• Other situations judged by the investigators not to be suitable for the clinical trial.