De-escalation from ticagrelor to clopidogrel in patients with acute myocardial infarction: the TALOS-AMI high bleeding risk (HBR) substudy
Authors' conclusion
In stabilised acute myocardial infarction patients, unguided de-escalation from ticagrelor to clopidogrel was associated with a lower rate of net adverse clinical outcomes irrespective of HBR status. The effect of de-escalation of P2Y12 inhibition on reducing haemorrhagic events was greater in patients with HBR.
Study context
- Population
- Stabilised acute MI patients after percutaneous coronary intervention (PCI), by HBR status (modified Academic Research Consortium (ARC) criteria)589 (22.4%) HBR
- Participants
- 2,625 patients
- Comparison
- De-escalation vs ticagrelor plus aspirin, by HBR status
Methodological detailsnon-prespecified post hoc analysis
- Non-prespecified post hoc analysis
Primary result
As reported in the abstract
Net adverse clinical events, by HBR status (subgroup) · 1 year post-PCI
De-escalation vs Active controlHazard ratio (95% CI)
HBR
0.47(0.26–0.84)
non-HBR
0.59(0.41–0.84)
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| BARC bleeding type 3 or 5, HBR patientsLess common among HBR patients only | 0.24 (0.07–0.84) | |
| 0.050.21520Hazard ratio (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
De-escalation from ticagrelor to clopidogrel in patients with acute myocardial infarction: the TALOS-AMI HBR substudy. EuroIntervention. Published 4 December 2023. doi:10.
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