Ticagrelor monotherapy versus aspirin monotherapy at 12 months after percutaneous coronary intervention
| Autor: | Masafumi Ono, Hironori Hara, Hideyuki Kawashima, Chao Gao, Rutao Wang, Joanna J. Wykrzykowska, Jan J. Piek, Scot Garg, Christian Hamm, Philippe Gabriel Steg, Marco Valgimigli, Stephan Windecker, Pascal Vranckx, Yoshinobu Onuma, Patrick Serruys Serruys |
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| Přispěvatelé: | Graduate School, Cardiology, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, ACS - Amsterdam Cardiovascular Sciences, ACS - Heart failure & arrhythmias |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Ticagrelor
Percutaneous Coronary Intervention Treatment Outcome All institutes and research themes of the Radboud University Medical Center Aspirin Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Myocardial Infarction Humans Drug Therapy Combination Hemorrhage Cardiology and Cardiovascular Medicine Platelet Aggregation Inhibitors |
| Zdroj: | Eurointervention, 18, E377-e388 Eurointervention, 18(5), E377-E388. EUROPA EDITION EuroIntervention, 18(5), e377-e388. EuroPCR Eurointervention, 18, 5, pp. E377-e388 |
| ISSN: | 1774-024X |
| DOI: | 10.4244/eij-d-21-00870 |
| Popis: | Background: The optimal antiplatelet strategy in the second year after percutaneous coronary intervention (PCI) remains unclear.Aims: We aimed to compare ticagrelor monotherapy with aspirin monotherapy on clinical outcomes beyond 1 year post-PCI.Methods: This post hoc subanalysis of the open-label, all-comers, randomised GLOBAL LEADERS trial, which compared 23-month ticagrelor monotherapy following 1-month dual antiplatelet therapy (DAPT) with 12-month aspirin monotherapy following 12-month DAPT, only included patients who, at 12 months, were free from ischaemic and bleeding events and were adherent to their assigned antiplatelet therapy. The incidences of ischaemic events (all-cause death, any myocardial infarction, or any stroke) and bleeding events (Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) during the second year (12-24 months) were compared between patients receiving either ticagrelor or aspirin monotherapy.Results: The present analysis included 11,121 (ticagrelor monotherapy n=5,308, and aspirin monotherapy n=5,813) of the 15,991 patients enrolled in GLOBAL LEADERS. During the second year, the ischaemic composite endpoint was lower with ticagrelor monotherapy compared to aspirin monotherapy (1.9% vs 2.6%: log-rank p=0.014, adjusted hazard ratio [HR] 0.74, 95% confidence interval [CI]: 0.58-0.96; p=0.022), which was primarily driven by a reduced risk of myocardial infarction. In contrast, BARC type 3 or 5 bleeding was numerically higher with ticagrelor monotherapy (0.5% vs 0.3%: log-rank p=0.051, adjusted HR 1.89, 95% CI: 1.03-3.45; p=0.005).Conclusions: Patients free from events at the end of the first year post-PCI and who adhered to their prescribed regimen had a reduced risk of ischaemic events compared to aspirin mootherapy in the second year post-PCI.ClinicalTrials.gov: NCT01813435 |
| Databáze: | OpenAIRE |
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