Ticogrelor monotherapy post PCI associated with similar rates of revascularization as duel antiplatelet therapy

New insights from the TWILIGHT trial confirmed that ticagrelor monotherapy after three months of ticagrelor plus aspirin was related to comparable charges of recurrent coronary revascularization, main adversarial cardiac and cerebrovascular occasions (MACCE) and a decrease danger of web adversarial scientific occasions (NACE) in contrast with duel antiplatelet remedy (DAPT). The outcomes from the randomized management trial of greater than 7,000 sufferers have been offered at the moment as late-breaking scientific analysis on the Society for Cardiovascular Angiography & Interventions (SCAI) 2023 Scientific Classes.

Regardless of advances in percutaneous coronary intervention (PCI) strategies, gadgets and secondary prevention, repeat revascularization stays a priority and is related to elevated morbidity, hospitalization and healthcare prices.

Within the TWILIGHT trial, high-risk sufferers who have been event-free and adherent to a ticagrelor-based DAPT for 3 months after PCI have been randomized to ticagrelor plus aspirin or ticagrelor plus placebo for 12 further months. The first endpoint was repeat revascularization attributable to recurrent or persistent symptomatic myocardial ischemia. Secondary endpoints included goal lesion revascularization (TLR), goal vessel revascularization (TVR) and main adversarial cardiac and cerebrovascular occasions (MACCE) and web adversarial scientific occasions (NACE). All endpoints have been adjudicated and assessed at 12 months after randomization within the per-protocol inhabitants.

Amongst 7,039 sufferers, ticagrelor monotherapy and ticagrelor plus aspirin have been related to an identical danger of repeat revascularization (7.1% vs 6.6%, HR 1.09, 95% CI 0.90-1.30), TLR, TVR and MACCE, whereas NACE was decrease with ticagrelor monotherapy. The outcomes additionally confirmed that clinically-driven revascularization was related to an extra danger for subsequent dying, myocardial infarction or stroke (aHR 2.92, 95% CI 1.82—4.67).

“In high-risk PCI sufferers, it is vital to minimize the prevalence of repeat revascularization,” stated Usman Baber, M.D., Affiliate Professor of Medication on the College of Oklahoma Well being Sciences Middle, and lead creator of the research. “The findings offered at the moment from the TWILIGHT trial present a better understanding of the affect of DAPT and ticagrelor monotherapy following PCI for the scientific group.”