Impact of Ticagrelor Monotherapy on Two-Year Clinical Outcomes in Patients with Long Stenting: A Post Hoc Analysis of the Global Leaders Trial.

Takahashi, Kuniaki; Chichareon, Ply; Modolo, Rodrigo; Kogame, Norihiro; Chang, Chun Chin; Tomaniak, Mariusz; Moschovitis, Aris; Curzen, Nick; Haude, Michael; Jung, Werner; Holmvang, Lene; Garg, Scot; Tijssen, Jan G P; Wykrzykowska, Joanna J; de Winter, Robbert J; Hamm, Christian; Steg, Philippe Gabriel; Stoll, Hans-Peter; Onuma, Yoshinobu; Valgimigli, Marco; ... (2020). Impact of Ticagrelor Monotherapy on Two-Year Clinical Outcomes in Patients with Long Stenting: A Post Hoc Analysis of the Global Leaders Trial. EuroIntervention, 16(8), pp. 634-644. Europa Digital & Publishing 10.4244/EIJ-D-19-00498

[img] Text
51_31498113 Impact of ticagrelor monotherapy.pdf - Accepted Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (2MB) | Request a copy

AIMS

To evaluate the impact of a novel antiplatelet regimen in patients with increasing total stent length (TSL).

METHODS AND RESULTS

This is a post-hoc analysis of the Global Leaders trial, a prospective, multi-centre, open-label, randomised trial, investigating the impact of the experimental strategy (one-month dual antiplatelet regimen [DAPT] followed by 23-month ticagrelor monotherapy) versus the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) in patients with Biolimus A9-eluting stent (BES). The primary endpoint was the composite of the all-cause death and new Q-wave myocardial infarction (MI), and the secondary endpoint was Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding at two years. To investigate the association between total stent length and outcomes, groups were compared in quartiles according to TSL, and the fourth quartile group was at significantly higher ischemic risk at two years. In that stratum (TSL≥ 46mm), the experimental strategy significantly reduced the risk of the primary endpoint (hazard ratio [HR]:0.67; 95% confidence interval [CI]:0.49-0.90; Pinteraction=0.043), while demonstrating a similar risk of BARC type 3 or 5 bleeding (HR:0.99; 95% CI:0.66-1.49; Pinteraction =0.975).

CONCLUSIONS

Ticagrelor monotherapy potentially could balance ischemic and bleeding risks, thereby achieving a net clinical benefit in patients with TSL≥ 46 mm with BES.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Valgimigli, Marco and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

10 Feb 2020 13:55

Last Modified:

25 Oct 2020 01:31

Publisher DOI:

10.4244/EIJ-D-19-00498

PubMed ID:

31498113

BORIS DOI:

10.7892/boris.139079

URI:

https://boris.unibe.ch/id/eprint/139079

Actions (login required)

Edit item Edit item
Provide Feedback