Can Limiting Dual Antiplatelet Therapy to 3 Months Reduce Bleeding?

Ticagrelor monotherapy was associated with less bleeding at 1 year than continued dual antiplatelet therapy and no higher risks for death, myocardial infarction, or stroke.

In a multicenter trial sponsored by the manufacturer of the P2Y₁₂ inhibitor ticagrelor (NCT02270242), researchers compared 1-year outcomes with two treatment regimens after percutaneous coronary intervention (PCI). The 9006 patients had both high-risk clinical and angiographic features for bleeding or ischemic events, received a drug-eluting stent (DES), and were treated for 3 months with ticagrelor plus aspirin.

At 3 months, 7119 patients underwent randomization (mean age, 65; diabetes, 37%; PCI for acute coronary syndrome, 65%) to continue this regimen or to receive ticagrelor alone. The primary endpoint — major bleeding types 2, 3, or 5, as defined by the Bleeding Academic Research Consortium, from randomization to 1 year later — occurred…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)