Ticagrelor monotherapy in patients with chronic kidney disease undergoing percutaneous coronary intervention: TWILIGHT-CKD
Authors' conclusion
Among CKD patients undergoing PCI, ticagrelor monotherapy reduced the risk of bleeding without a significant increase in ischaemic events as compared with ticagrelor plus aspirin.
Study context
- Population
- High-risk patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent, event-free after 3 months of ticagrelor plus aspirin; Chronic kidney disease (CKD) = estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m²1,111 (16.3%) with CKD
- Participants
- 6,835 patients
- Comparison
- Ticagrelor plus placebo vs ticagrelor plus aspirin, by CKD status
- Primary endpoint
- Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding
Methodological detailsprespecified subanalysis, placebo-controlled
- Prespecified subanalysis
- Placebo-controlled
Primary result
As reported in the abstract
BARC type 2, 3, or 5 bleeding, by CKD (subgroups)
Ticagrelor plus placebo vs Ticagrelor plus aspirinHazard ratio (95% CI)
CKD: 4.6% vs. 9.0%
0.50(0.31–0.80)
No CKD: 4.0% vs. 6.7%
0.59(0.47–0.75)
Further findings
| Outcome | Ticagrelor plus placebo | Ticagrelor plus aspirin | HR (95% CI) | |
|---|---|---|---|---|
| Death, MI, or stroke, by CKD (subgroups)CKD | 7.9% | 5.7% | 1.40 (0.88–2.22) | |
| Death, MI, or stroke, by CKD (subgroups)No CKD | 3.2% | 3.6% | 0.90 (0.68–1.20) | |
| 0.512Hazard ratio (log scale) |
- Death, MI, or stroke, by CKD (subgroups): Pinteraction = 0.111
Death, MI, or stroke, by CKD (subgroups)
- Not significantly different between randomized groups
Original publication
Ticagrelor monotherapy in patients with chronic kidney disease undergoing percutaneous coronary intervention: TWILIGHT-CKD. Eur Heart J. Published 23 August 2021. doi:10.
Summarised from the published abstract; every number is checked against it