Coronary disease & ACS

Ticagrelor Monotherapy or Aspirin Plus Prasugrel After Percutaneous Coronary Intervention: A Network Meta-Analysis

JACC AdvPublished frequentist random-effects network meta-analysis

Authors' conclusion

In this network meta-analysis of predominantly ACS patients undergoing PCI, ticagrelor monotherapy reduced major bleeding compared with 12 months of aspirin plus prasugrel, whereas it did not meet noninferiority for MACCE. Direct randomized comparisons are warranted. (Ticagrelor Monotherapy or Aspirin Plus Prasugrel After Percutaneous Coronary Intervention: A Network Meta-Analysis; CRD420261322968).

Study context

Population
Patients after percutaneous coronary intervention (PCI) (predominantly ACS)
Participants
27,225 patients · 7 randomized controlled trials
Comparison
Ticagrelor monotherapy and aspirin plus prasugrel were compared indirectly through ticagrelor-based dual antiplatelet therapy (DAPT).
Methodological detailsRandomized controlled trials
  • Randomized controlled trials

Pooled result

As reported in the abstract

MACCE and major bleeding
Ticagrelor monotherapy vs aspirin plus prasugrelIncidence rate ratio (95% CI)
MACCE; P for noninferiority = 0.33
1.09(0.86–1.38)
Major bleeding; lower with ticagrelor monotherapy
0.54(0.37–0.80)

Further pooled results

MACCE by diabetes status (interaction)

Interaction between P2Y12 inhibitor strategy and diabetes status for MACCE
Pint = 0.04

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Ticagrelor Monotherapy or Aspirin Plus Prasugrel After Percutaneous Coronary Intervention: A Network Meta-Analysis. JACC Adv. Published 5 October 2026. doi:10.1016/j.jacadv.2026.103298

Summarised from the published abstract; every number is checked against it

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