![]() “To have two independently done trials essentially reaching the same conclusion that this strategy of ticagrelor monotherapy essentially cuts major bleeding in half is very comforting,” Bhatt said. ![]() ” That trial also showed that going with ticagrelor monotherapy after 3 months of DAPT reduced bleeding without increasing ischemic events, albeit in a broader population of high-risk PCI patients. “This finding indicates that ticagrelor monotherapy could be an optimal strategy, balancing both ischemic and bleeding risks for patients with ACS treated by ultrathin, biodegradable-polymer, sirolimus-eluting stents,” Jang concluded.Ĭommenting during a panel discussion after Jang’s presentation, Deepak Bhatt, MD (Brigham and Women’s Hospital, Boston, MA), gave a nod toward some of the trial’s limitations cited by Jang-it was open-label, lacked a placebo control, and had limited statistical power-but said TICO “is an important independent confirmation of TWILIGHT. ![]() The difference was mainly driven by a reduction in major bleeding (1.7% vs 3.0% HR 0.56 95% CI 0.34-0.91), he reported at the virtual American College of Cardiology (ACC) 2020 Scientific Session. ![]() Switching to ticagrelor (Brilinta AstraZeneca) monotherapy after 3 months of dual antiplatelet therapy (DAPT) reduces major bleeding without increasing ischemic risk compared with 12 months of DAPT in ACS patients implanted with a second-generation DES, results of the TICO trial show.ĭropping aspirin after 3 months reduced the risk of net adverse clinical events (NACE), a composite of TIMI major bleeding and major adverse cardiac and cerebrovascular events, through 1 year (3.9% vs 5.9% HR 0.66 95% CI 0.48-0.92), according to Yangsoo Jang, MD, PhD (Yonsei University College of Medicine, Seoul, Korea). ![]()
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