Key result
Initial ticagrelor monotherapy shows 0% MACE and major bleeding in high-risk ACS patients post-PCI.
Why the study?
The effect of ticagrelor monotherapy as an initial antiplatelet regimen after PCI in patients at high bleeding risk was unknown.
Does initial ticagrelor monotherapy prevent MACEs and major bleeding in ACS patients at high bleeding risk after PCI?
Case Report (n=12)
Unblinded
No
Does initial ticagrelor monotherapy prevent MACEs and major bleeding in ACS patients at high bleeding risk after PCI?
Initial ticagrelor monotherapy after PCI appears safe and effective in a small case series of high bleeding risk ACS patients, warranting further randomized trials.
Hypothesis-generating in high-bleeding-risk ACS post-PCI; does not support practice change without randomized trials.
Objective: Short-term duration of dual antiplatelet therapy (DAPT) followed by ticagrelor monotherapy after percutaneous coronary intervention (PCI) among patients at high bleeding risk (HBR) was identified in numerous clinical trials, but the effect of ticagrelor monotherapy as an initial regimen was unknown. To explore the efficacy and safety of ticagrelor monotherapy after PCI in patient at HBR. Patients and methods: This were case series report at single center, unblinded without control group. A total of 12 acute coronary syndrome (ACS) patients at HBR between November 2020 and December 2021 were enrolled,17 newer generation drug-eluting stents (DES),2 drug-coated balloon (DCB) and 1 bioresorbable scaffolds (BRS) were implanted. Ticagrelor monotherapy was prescribed as an initial antiplatelet strategy after PCI. Study endpoints were major adverse cardiovascular events (MACEs) and major bleeding events at 1-month to 1-year follow-up. Results: During hospitalization and at the 1–3-month follow-up, there were no adverse clinical events, including ischemic or major bleeding events, in any of the patients. Six patients completed 1-year clinical event-free follow-up, 2 of them had well angiographic outcomes after PCI for one year. Conclusions: Ticagrelor monotherapy as an initial antiplatelet therapy was safety and efficacy in these patients at HBR undergoing PCI. Further prospective studies and randomized clinical trials are warranted.
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Cui et al. (2022) conducted a case report in Acute coronary syndrome (ACS) at high bleeding risk (HBR) (n=12). Ticagrelor monotherapy was evaluated on Major adverse cardiovascular events (MACEs) and major bleeding events. Initial ticagrelor monotherapy after PCI in 12 ACS patients at high bleeding risk resulted in 0% major adverse cardiovascular or bleeding events during follow-up.
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