Safety and Efficacy of Ticagrelor Monotherapy in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: An Individual Patient Data Meta-Analysis of TWILIGHT and TICO Randomized Trials
Pooled result · BARC 3 or 5 bleedingResult — go to the resultHazard ratio 0.37 95% CI 0.24–0.56Authors' conclusion
Among patients with ACS undergoing PCI who have completed a 3-month course of dual antiplatelet therapy, discontinuation of aspirin followed by ticagrelor monotherapy significantly reduced major bleeding without incremental ischemic risk compared with ticagrelor plus aspirin.
Study context
- Population
- Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), free of major ischemic or bleeding event in first 3 months (TWILIGHT and TICO)TWILIGHT and TICO
- Participants
- 7,529 patients
- Comparison
- Ticagrelor monotherapy vs ticagrelor plus aspirin after 3-month DAPT
- Outcome
- BARC type 3 or 5 bleeding
- Follow-up
- Between 3 and 12 months after index PCI
Methodological detailsintention-to-treat, one-stage Cox regression
- Intention-to-treat
- One-stage Cox regression
Pooled result
BARC 3 or 5 bleeding · 3–12 months
Hazard ratio
0.37
95% CI 0.24–0.56
P < 0.001
By group
Ticagrelor monotherapy vs Ticagrelor plus aspirin
HR 0.37 (95% CI 0.24–0.56); P < 0.001
As reported in the abstract
Further pooled results
Biomarker-positive ACS (subgroup)
- Findings unchanged among patients presenting with biomarker-positive ACS
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Safety and Efficacy of Ticagrelor Monotherapy in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: An Individual Patient Data Meta-Analysis of TWILIGHT and TICO Randomized Trials. Circulation. Published 23 October 2023. doi:10.
Summarised from the published abstract; every number is checked against it