Prolonged Dual Antiplatelet Therapy After Myocardial Infarction

In an intent-to-treat analysis of the PEGASUS-TIMI 54 trial, dual antiplatelet therapy with the P2Y₁₂ receptor antagonist ticagrelor (Brilinta; 60 mg twice daily) plus aspirin compared with aspirin alone for 3 years significantly lowered risk for cardiovascular (CV)-related death, myocardial infarction (MI), or stroke (7.8% vs. 9.0%) but led to excess major bleeding (2.2% vs. 1.3%) in patients who experienced MIs 1 to 3 years previously (NEJM JW Gen Med May 15 2015 and N Engl J Med 2015; 372:1791). In a new study, researchers modeled outcomes of prolonged dual antiplatelet therapy in a population-based cohort of “real-world” U.K. patients who would have qualified for PEGASUS.

Among more than 7200 real-world post-MI patients who survived for …