Ticagrelor monotherapy for acute coronary syndrome: an individual patient data meta-analysis of TICO and T-PASS trials
Authors' conclusion
In ACS patients undergoing DES implantation, ticagrelor monotherapy after short-term DAPT was associated with less major bleeding without a concomitant increase in ischaemic events compared with ticagrelor-based 12-month DAPT.
Study context
- Population
- Acute coronary syndrome (ACS) patients undergoing drug-eluting stent (DES) implantation
- Participants
- 5,906 patients2 RCTs
- Comparison
- Ticagrelor monotherapy after short-term (≤3 months) dual antiplatelet therapy (DAPT) vs ticagrelor-based 12-month DAPT
- Outcome
- Co-primary: ischaemic endpoint (all-cause death, MI or stroke) and bleeding endpoint (BARC type 3 or 5 bleeding)
- Follow-up
- 1 year
Methodological detailsco-primary endpoints
- Co-primary endpoints
Pooled result
As reported in the abstract
Ticagrelor monotherapy
- Ischaemic endpoint
- 1.9%
- Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding
- 2.4%
Ticagrelor-based DAPT
- Ischaemic endpoint
- 2.5%
- BARC 3 or 5 bleeding
- 4.5%
Ischaemic endpoint
Ticagrelor monotherapy1.9%
Ticagrelor-based DAPT2.5%
Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding
Ticagrelor monotherapy2.4%
Ticagrelor-based DAPT4.5%
Ticagrelor monotherapy vs Ticagrelor-based DAPTAdjusted hazard ratio (95% CI)P value
Ischaemic endpoint
0.79(0.56–1.13)
P = 0.194Bleeding endpoint
0.54(0.40–0.72)
P < 0.001Further pooled results
Secondary aggregate data meta-analysis incl. ACS subgroup of additional RCTs
- Results consistent with primary analysis
Original publication
Ticagrelor monotherapy for acute coronary syndrome: an individual patient data meta-analysis of TICO and T-PASS trials. Eur Heart J. Published 16 May 2024. doi:10.
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