Coronary disease & ACSRandomised controlled trial
Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority Trial
- Randomised controlled trial
- open-label
- non-inferiority
- multicentre (24 centres, South Korea)
Authors' conclusion
This study provides evidence that stopping aspirin within 1 month for ticagrelor monotherapy is both noninferior and superior to 12-month DAPT for the 1-year composite outcome of death, myocardial infarction, stent thrombosis, stroke, and major bleeding, primarily because of a significant reduction in major bleeding, among patients with acute coronary syndrome receiving drug-eluting stent implantation.
Study context
- Population
- Patients with ACS undergoing drug-eluting stent implantation2,823 (99.0%) completed
- Participants
- 2,850 patients
- Comparison
- Ticagrelor monotherapy vs 12-month dual antiplatelet therapy (DAPT)
- Ticagrelor monotherapyn = 1,426
- 12-month DAPTn = 1,424reference
- Primary endpoint
- Net clinical benefit: all-cause death, MI, definite or probable stent thrombosis, stroke and major bleeding
- Follow-up
- 1 year after the index procedure
Primary result
As reported in the abstract
1 year
Hazard ratio
0.54
95% CI 0.37–0.80
P < 0.001
Events by treatment group
Ticagrelor monotherapy vs 12-month DAPT
HR 0.54 (95% CI 0.37–0.80); P < 0.001
Secondary outcomes
- Aspirin discontinuation (Ticagrelor monotherapy)
- 16 · median · IQR 12–25 · days
Safety
| Outcome | Ticagrelor monotherapy | 12-month DAPT | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Major bleeding | 1.2% | 3.4% | 0.35 (0.20–0.61) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority Trial. Circulation. Published 25 October 2023. doi:10.1161/circulationaha.123.066943
Summarised from the published abstract; every number is checked against it