Ono, Masafumi; Hara, Hironori; Kawashima, Hideyuki; Gao, Chao; Wang, Rutao; Wykrzykowska, Joanna J; Piek, Jan J; Garg, Scot; Hamm, Christian; Steg, Philippe Gabriel; Valgimigli, Marco; Windecker, Stephan; Vranckx, Pascal; Onuma, Yoshinobu; Serruys, Patrick W (2022). Ticagrelor monotherapy versus aspirin monotherapy at 12 months after percutaneous coronary intervention: a landmark analysis of the GLOBAL LEADERS trial. EuroIntervention, 18(5), e377-e388. Europa Digital & Publishing 10.4244/EIJ-D-21-00870
Full text not available from this repository.BACKGROUND
The optimal antiplatelet strategy in the second year after percutaneous coronary intervention (PCI) remains unclear.
AIMS
We aimed to compare ticagrelor monotherapy with aspirin monotherapy on clinical outcomes beyond 1 year post-PCI.
METHODS
This post hoc subanalysis of the open-label, all-comers, randomised GLOBAL LEADERS trial, which compared 23-month ticagrelor monotherapy following 1-month dual antiplatelet therapy (DAPT), with 12-month aspirin monotherapy following 12-month DAPT, only included patients who, at 12 months, were free from ischaemic and bleeding events, and adherent to their assigned antiplatelet therapy. The incidences of ischaemic events (all-cause death, any myocardial infarction, or any stroke) and bleeding events (Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) during the second year (12-24 months) were compared between patients receiving either ticagrelor or aspirin monotherapy.
RESULTS
The present analysis included 11,121 (ticagrelor monotherapy n=5,308, and aspirin monotherapy n=5,813) of the 15,991 patients enrolled in GLOBAL LEADERS. During the second year, the ischaemic composite endpoint was lower with ticagrelor monotherapy compared to aspirin monotherapy (1.9% vs 2.6%: log-rank p=0.014, adjusted hazard ratio [HR] 0.74, 95% confidence interval [CI]: 0.58-0.96; p=0.022), which was primarily driven by a reduced risk of myocardial infarction. In contrast, BARC type 3 or 5 bleeding was numerically higher with ticagrelor monotherapy (0.5% vs 0.3%: log-rank p=0.051, adjusted HR 1.89, 95% CI: 1.03-3.45; p=0.005).
CONCLUSIONS
Patients free from events at the end of the first year post-PCI and who adhered to their prescribed regimen had a reduced risk of ischaemic events compared to aspirin monotherapy in the second year post-PCI.
CLINICALTRIALS
gov: NCT01813435.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Windecker, Stephan |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1774-024X |
Publisher: |
Europa Digital & Publishing |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
11 Mar 2022 12:24 |
Last Modified: |
05 Dec 2022 16:14 |
Publisher DOI: |
10.4244/EIJ-D-21-00870 |
PubMed ID: |
35260381 |
URI: |
https://boris.unibe.ch/id/eprint/167241 |
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