Bleeding and Ischemic Risks of Ticagrelor Monotherapy After Coronary Interventions
Authors' conclusion
Three months after PCI, discontinuing aspirin and maintaining ticagrelor monotherapy reduces bleeding in both higher-bleeding risk and lower-bleeding risk patients compared with continued DAPT. This benefit does not appear to be offset by greater ischemic risk.
Study context
- Population
- High-risk patients undergoing percutaneous coronary intervention (PCI)
- Participants
- 7,119 patients
- Comparison
- Ticagrelor monotherapy vs continued dual antiplatelet therapy (DAPT) after 3 months of DAPT
- Primary endpoint
- BARC-2/3/5 bleeding and MACCE (CV death, nonfatal MI, nonfatal ischemic stroke) across bleeding and ischemic risk strata
Methodological detailsmultivariable Cox regression risk models
- Multivariable Cox regression risk models
Primary result
As reported in the abstract
Bleeding (BARC-2/3/5) by bleeding and ischemic risk strata
- Consistent reduction in bleeding with ticagrelor monotherapy vs DAPT across bleeding risk strata
- P interaction = 0.54
- Consistent reduction in bleeding with ticagrelor monotherapy vs DAPT across ischemic risk strata
- P interaction = 0.11
Further findings
Event rates in total study group
- BARC-2/3/5 bleeding
- 391 (5.5%)
- MACCE
- 258 (3.6%)
Original publication
Bleeding and Ischemic Risks of Ticagrelor Monotherapy After Coronary Interventions. J Am Coll Cardiol. Published 22 August 2023. doi:10.
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