{
  "abstract": "Background: Recent studies have demonstrated the superior benefits of clopidogrel compared to aspirin in reducing mortality, myocardial infarction, stroke, and hospitalization in chronic stable patients with coronary stenting. Furthermore, dual pathway inhibition by combining low-dose rivaroxaban with aspirin (DPI) has shown superior effects in preventing cardiovascular death, myocardial infarction, and stroke in stable atherosclerotic patients. However, no studies have directly compared these treatment strategies in the same population. This randomized controlled trial aims to compare clopidogrel-based antiplatelet therapy with or without aspirin (CAPT) to DPI in a 1:1 ratio in patients with high-risk coronary artery disease (CAD) or in patients with both CAD and peripheral artery disease (PAD).\n\nMethods: Optimal strategy for treatment of Atherosclerotic cardiovascular disease—comparison of Clopidogrel-based Antiplatelet agent treatment versus aspirin plus low dose Rivaroxaban Therapy (OACART) trial is a randomized multi-center study comparing the performance of the maintaining CAPT or DPI in a 1:1 ratio. The trial is powered for the non-inferiority of the CAPT in patients with chronic stable high-risk CAD or CAD+PAD to DPI with respect to the primary and secondary efficacy endpoints at 36 months.\n\nResults: Between November 2023 and April 2026, we will recruit 2758 participants from multi-center in Korea, and we will examine the net clinical outcome, including all-cause death, any myocardial infarction, any stroke, any ischemia-driven revascularization (CAD or PAD), acute limb ischemia, any major or minor amputations, any acute thromboembolism, and International Society on Thrombosis and Haemostasis major bleeding at 36 months after study enrollment.\n\nConclusions: OACART trial will provide the optimal antithrombotic treatment strategy for patients with stable high-risk atherosclerosis.\n\nTrial registration: Clinical Research Information Service (CRIS) of Republic of Korea, KCT0008458, registered on May 22, 2023. https://cris.nih.go.kr/cris/search/detailSearch.do?seq=28968&search_page=L\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13063-026-09899-7.",
  "abstract_shown": true,
  "affiliations": [
    "Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-Si, Korea",
    "Department of Internal Medicine, Seoul National University, Seoul, Korea",
    "Department of Internal Medicine, Cardiology Center, Seoul National University Hospital, Seoul, South Korea",
    "Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea",
    "Korea University Anam Hospital, Seoul, Republic of Korea",
    "Chungnam National University Sejong Hospital, Sejong-Si, Republic of Korea",
    "Korea University Guro Hospital, Seoul, Republic of Korea",
    "Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea",
    "Kangwon National University Hospital, Gangwon-Do, Chuncheon-Si, Republic of Korea",
    "Wonju Severance Christian Hospital, Wonju-Si, Gangwon-Do Republic of Korea",
    "Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea",
    "National Health Insurance Service Ilsan Hospital, Goyang-Si, Gyeonggi-Do Republic of Korea",
    "Changwon Fatima Hospital, Changwon-Si, Gyeongsangnam-Do Republic of Korea",
    "Hallym University Sacred Heart Hospital, Anyang-Si, Gyeonggi-Do South Korea",
    "Bucheon Sejong Hospital, Bucheon-Si, Gyeonggi-Do Republic of Korea",
    "Chonbuk National University Hospital, Jeonju-Si, Jeollabuk-Do Republic of Korea",
    "Inha University Hospital, Incheon, Republic of Korea",
    "Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin, Republic of Korea",
    "Myongji Hospital, Goyang-Si, Gyeonggi-Do Republic of Korea",
    "Chonnam National University Hospital, Gwangju, Republic of Korea",
    "Chungnam National University Hospital, Daejeon, Republic of Korea",
    "St. Carollo Hospital, Suncheon-Si, Jeollanam-Do Republic of Korea",
    "Jeju National University Hospital, Jeju-Si, Republic of Korea",
    "Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University, Cheonan, South Korea",
    "Kwangju Christian Hospital, Gwangju, Republic of Korea"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 33,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Ju-Seung Kwun"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Chang-Hwan Yoon",
      "orcid": "0000-0001-6305-4442"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ki-Hyun Jeon"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Hyoung-won Cho"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jin Joo Park"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Si-Hyuck Kang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Wonjae Lee"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jung-Won Suh"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Tae-Jin Youn"
    },
    {
      "affs": [
        2
      ],
      "name": "Hyun-Jae Kang"
    },
    {
      "affs": [
        3
      ],
      "name": "Pil-ki Min"
    },
    {
      "affs": [
        4
      ],
      "name": "Cheol Woong Yu"
    },
    {
      "affs": [
        5
      ],
      "name": "Jae-Hwan Lee"
    },
    {
      "affs": [
        6
      ],
      "name": "Seung-Woon Rha"
    },
    {
      "affs": [
        7
      ],
      "name": "Sanghoon Shin"
    },
    {
      "affs": [
        8
      ],
      "name": "Bong-Ki Lee"
    },
    {
      "affs": [
        9
      ],
      "name": "Young Jin Youn"
    },
    {
      "affs": [
        10
      ],
      "name": "Young-Guk Ko"
    },
    {
      "affs": [
        11
      ],
      "name": "Ji-Yong Jang"
    },
    {
      "affs": [
        12
      ],
      "name": "Jae-Kwang Lee"
    },
    {
      "affs": [
        13
      ],
      "name": "Kyoung-Ha Park"
    },
    {
      "affs": [
        14
      ],
      "name": "Young Jin Choi"
    },
    {
      "affs": [
        15
      ],
      "name": "Sang-Rok Lee"
    },
    {
      "affs": [
        16
      ],
      "name": "Sang-Don Park"
    },
    {
      "affs": [
        17
      ],
      "name": "Deok-Kyu Cho"
    },
    {
      "affs": [
        18
      ],
      "name": "Yun-Hyeong Cho"
    },
    {
      "affs": [
        19
      ],
      "name": "Ju Han Kim"
    },
    {
      "affs": [
        20
      ],
      "name": "Jin-Ok Jeong"
    },
    {
      "affs": [
        21
      ],
      "name": "Janghyun Cho"
    },
    {
      "affs": [
        22
      ],
      "name": "Song-Yi Kim"
    },
    {
      "affs": [
        23
      ],
      "name": "Tae Soo Kang"
    },
    {
      "affs": [
        24
      ],
      "name": "Seung-Uk Lee"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "In-Ho Chae"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2gs2yj8eq89sb.bib",
  "cited_by": 0,
  "doi": "10.1186/s13063-026-09899-7",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711889/",
  "id": "2gs2yj8eq89sb",
  "issns": [
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  "landing_url": "https://doi.org/10.1186/s13063-026-09899-7",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "heading",
      "Study Protocol"
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  "pmcid": "PMC13711889",
  "pmid": "42934720",
  "published": "2026-07-30",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/2gs2yj8eq89sb.ris",
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      "origin": "openalex:2705|Antiplatelet Therapy and Cardiovascular Diseases",
      "subfield": "cardiovascular"
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  "title": "Optimal strategy for treatment of atherosclerotic cardiovascular disease—comparison of clopidogrel-based antiplatelet agent treatment versus aspirin plus low dose rivaroxaban therapy (OACART study): a study protocol for a multicenter, open-label, randomized, non-inferiority trial",
  "title_text": "Optimal strategy for treatment of atherosclerotic cardiovascular disease—comparison of clopidogrel-based antiplatelet agent treatment versus aspirin plus low dose rivaroxaban therapy (OACART study): a study protocol for a multicenter, open-label, randomized, non-inferiority trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:35Z",
  "url": "https://research.draconitic.com/paper/2gs2yj8eq89sb",
  "venue": "Trials",
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