Toba T, et al. - Researchers conducted this study to further examine the impact of dual antiplatelet therapy (DAPT) with adjusted-dose prasugrel (3.75 mg/day) for Japanese patients with respect to local arterial healing following elective percutaneous coronary intervention (PCI). In the ROUTE-01 elective study, enrollees included 123 patients who underwent elective PCI with everolimus-eluting stents (EESs) under DAPT with a combination of adjusted-dose prasugrel and aspirin. Performing serial optical coherence tomography (OCT) at the index PCI and 9-month follow-up, the investigators assessed the relationship between in-stent thorombus (IST) and residual platelet reactivity measuring platelet reactivity unit. Multivariate logistic regression analysis identified irregular protrusion on post-PCI OCT, not CYP2C19 loss-of-function polymorphisms as the independent predictor for IST on 9-month OCT. Findings suggested the feasibility of adjusted-dose prasugrel and aspirin as a treatment option in Japanese patients treated with EESs in elective PCI.