Key result
Prolonged dual antiplatelet therapy with ticagrelor twice daily reduced the risk of cardiovascular death, myocardial infarction, or stroke by 16% compared to placebo in patients with a prior myocardial infarction.
Why the study?
Does prolonged dual antiplatelet therapy with ticagrelor reduce the risk of recurrent ischemic events in patients after myocardial infarction?
Does prolonged dual antiplatelet therapy with ticagrelor reduce the risk of recurrent ischemic events in patients after myocardial infarction?
Answers are grounded in this paper and cite their sources.
Prolonging DAPT with ticagrelor beyond 12 months in post-MI patients may improve survival and reduce recurrent ischemic events, supporting updates to ACS management guidelines.
The review article highlights concerns related to a low survival rate in patients after myocardial infarction (MI) and factors affecting it. The pivotal role is given to the issue of patient adherence to therapy after acute coronary events. The options to improve it as well as mechanisms to optimize medical therapy for patients after myocardial infarction, particularly the need for prolonged dual antiplatelet therapy (DAPT), have been identified. The rationale for changing the current guidelines for the management of patients with acute coronary syndromes (ACS) is based on the findings of the recently completed international clinical trial PE- GASUS-TIMI 54 with ticagrelor (Brilinta®), utilized as part of a DAPT regimen, that have demonstrated the efficacy and safety of DAPT prolongation after 12-month period in post-MI patients.
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Барбараш et al. (2015) conducted a review in Prior myocardial infarction (n=21,162). Ticagrelor vs. Placebo (on a background of aspirin) was evaluated on Cardiovascular death, myocardial infarction, or stroke (HR 0.84, 95% CI 0.77-0.96, p=0.004). Prolonged dual antiplatelet therapy with ticagrelor twice daily reduced the risk of cardiovascular death, myocardial infarction, or stroke by 16% compared to placebo in patients with a prior myocardial infarction.
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