Coronary disease & ACSMeta-analysis
Ticagrelor Monotherapy or Aspirin Plus Prasugrel After Percutaneous Coronary Intervention
- frequentist random-effects network meta-analysis
- Randomized controlled trials
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 Seven randomized controlled trials
- Comparison
- Ticagrelor monotherapy and aspirin plus prasugrel were compared indirectly through ticagrelor-based dual antiplatelet therapy (DAPT).
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. JACC Adv. Published 5 October 2026. doi:10.1016/j.jacadv.2026.103298
Summarised from the published abstract; every number is checked against it