1. Ticagrelor Monotherapy Versus Dual-Antiplatelet Therapy After PCI
- Author
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Marco Valgimigli, Roxana Mehran, Anna Franzone, Bruno R. da Costa, Usman Baber, Raffaele Piccolo, Eùgene P. McFadden, Pascal Vranckx, Dominick J. Angiolillo, Sergio Leonardi, Davide Cao, George D. Dangas, Shamir R. Mehta, Patrick W. Serruys, C. Michael Gibson, Gabriel P. Steg, Samin K. Sharma, Christian Hamm, Richard Shlofmitz, Christoph Liebetrau, Carlo Briguori, Luc Janssens, Kurt Huber, Maurizio Ferrario, Vijay Kunadian, David J. Cohen, Aleksander Zurakowski, Keith G. Oldroyd, Han Yaling, Dariuz Dudek, Samantha Sartori, Brian Kirkham, Javier Escaned, Dik Heg, Stephan Windecker, Stuart Pocock, Peter Jüni, Patrick Serruys, Shamir Mehta, Michael C. Gibson, Adnan Kastrati, Mitchel Krucoff, Magnus E. Ohman, Paul Gurbel, Timothy D. Henry, David Moliterno, Dierik Heg, Eugene McFadden, Steven O. Marx, Bruce Darrow, Nicola Corvaja, Douglas DeStefano, Newsha Ghodsi, Jose Meller, Theresa Franklin-Bond, Jin Young Cha, Zaha Waseem, Giora Weisz, Ran Kornowski, Keith Oldroyd, Upendra Kaul, Bernhard Witzenbichler, Vladimir Dzavik, Robert Gil, Gennaro Sardella, Edouard Benit, Roberto Diletti, Marcello Dominici, Ton Slagboom, Paweł Buszman, Leonardo Bolognese, Carlo Tumscitz, Krzysztof Bryniarski, Adel Aminian, Mathias Vrolix, Ivo Petrov, Scot Garg, Christoph Naber, Janusz Prokopczuk, and Philippe Gabriel Steg more...
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medicine.medical_specialty ,Aspirin ,animal structures ,business.industry ,medicine.medical_treatment ,Hazard ratio ,Percutaneous coronary intervention ,030204 cardiovascular system & hematology ,Lower risk ,medicine.disease ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Conventional PCI ,medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Ticagrelor ,Stroke ,medicine.drug - Abstract
Objectives The aim of this study was to compare ticagrelor monotherapy with dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stents. Background The role of abbreviated DAPT followed by an oral P2Y12 inhibitor after PCI remains uncertain. Methods Two randomized trials, including 14,628 patients undergoing PCI, comparing ticagrelor monotherapy with standard DAPT on centrally adjudicated endpoints were identified, and individual patient data were analyzed using 1-step fixed-effect models. The protocol was registered in PROSPERO ( CRD42019143120 ). The primary outcomes were the composite of Bleeding Academic Research Consortium type 3 or 5 bleeding tested for superiority and, if met, the composite of all-cause death, myocardial infarction, or stroke at 1 year, tested for noninferiority against a margin of 1.25 on a hazard ratio (HR) scale. Results Bleeding Academic Research Consortium type 3 or 5 bleeding occurred in fewer patients with ticagrelor than DAPT (0.9% vs. 1.7%, respectively; HR: 0.56; 95% confidence interval [CI]: 0.41 to 0.75; p Conclusions Ticagrelor monotherapy was associated with a lower risk for major bleeding compared with standard DAPT, without a concomitant increase in ischemic events. more...
- Published
- 2021
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