Short-term outcomes of ticagrelor monotherapy after primary percutaneous coronary intervention for ST-elevation myocardial infarction; a randomized pilot study

This randomized multicenter open-label pilot study assessed the safety of ticagrelor monotherapy directly after primary PCI versus dual antiplatelet therapy (DAPT) in 200 STEMI patients. At three months, major adverse cardiac and cerebral events occurred in 3.1% of the experimental group (n=99) versus 2.0% in the control group (n=101) (HR: 1.54; 95%CI: 0.26-9.24), clinically relevant bleeding was observed in 4.2% versus 8.9% (HR: 0.46, 95%CI: 0.14-1.48), and clinically relevant non-access site bleeding in 2.0% versus 7.9% (HR:0.25, 95%CI: 0.05-1.19). Although no significant difference in ischemic events was observed between the novel concept of ticagrelor monotherapy and DAPT, safety cannot be confirmed given the small number of events. Additionally, there was a tendency for a reduction in clinically relevant non-access site bleeding events. Clinical Trial Registration: ClinicalTrials.gov ID: NCT05986968 https://www.clinicaltrials.gov/study/NCT05986968.