Prasugrel or ticagrelor monotherapy vs dual antiplatelet treatment after percutaneous coronary intervention in acute coronary syndromes: a landmark analysis from the NEO-MINDSET trial
Primary result · Co-primary outcomes: ischaemic composite (all-cause death, MI, stroke or urgent target-vessel revascularization) and BARC type 2, 3 or 5 bleedingResult — go to the resultRisk difference 1.5% 95% CI .4%-2.6%Authors' conclusion
This prespecified 30-day landmark analysis suggests an excess of ischaemic risk with monotherapy vs DAPT in the first 30 days but not thereafter, whereas an aspirin-free strategy was consistently associated with fewer bleeding events within and after 30 days.
Study context
- Population
- ACS patients undergoing successful PCI with drug-eluting stents within 4 days of admission
- Participants
- 3,410 patients
- Comparison
- Potent P2Y12 inhibitor monotherapy vs DAPT
- Primary endpoint
- Co-primary: (i) all-cause death, MI, stroke or urgent target-vessel revascularization (ischaemic); (ii) BARC type 2, 3 or 5 bleeding; landmark early (0-30 days) and late (31-365 days)
- Follow-up
- 12 months
Methodological detailsprespecified landmark analysis
- Prespecified landmark analysis
Primary result
As reported in the abstract
Co-primary outcomes: ischaemic composite (all-cause death, MI, stroke or urgent target-vessel revascularization) and BARC type 2, 3 or 5 bleeding · 30 days (early landmark, 0-30 days)
Risk difference
1.5%
95% CI .4%-2.6%
P = 0.006
By group
Monotherapy
- Ischaemic outcome
- 3.3%
- BARC 2, 3 or 5 bleeding
- .6%
DAPT
- Ischaemic outcome
- 1.8%
- BARC 2, 3 or 5 bleeding
- 1.5%
Ischaemic outcome
Monotherapy3.3%
DAPT1.8%
BARC 2, 3 or 5 bleeding
Monotherapy.6%
DAPT1.5%
Monotherapy vs DAPT
risk difference 1.5% (95% CI .4%-2.6%); P = 0.006
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Prasugrel or ticagrelor monotherapy vs dual antiplatelet treatment after percutaneous coronary intervention in acute coronary syndromes: a landmark analysis from the NEO-MINDSET trial. Eur Heart J. Published 19 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it