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. (Request a copy)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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