Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/34481
Title: Ticagrelor alone or conventional dual antiplatelet therapy in patients with stable or acute coronary syndromes
Authors: Franzone, Anna
McFadden, Eugène P.
Leonardi, Sergio
Piccolo, Raffaele
VRANCKX, Pascal 
Serruys, Patrick W.
Hamm, Christian
Steg, Philippe Gabriel
Heg, Dik
Branca, Mattia
Jüni, Peter
Windecker, Stephan
Valgimigli, Marco
Issue Date: 2020
Publisher: 
Source: EuroIntervention, 16 (8) , p. 627 -633
Abstract: Aims: The aim of this study was to investigate the effect of ticagrelor monotherapy after one-month dual antiplatelet therapy (DAPT) or conventional DAPT in patients with or without acute coronary syndrome (ACS) in the GLOBAL LEADERS Adjudication Sub-StudY (GLASSY). Methods and results: Risk estimates were expressed as rate ratios (RR) with 95% confidence intervals (CI). A total of 3,840 ACS and 3,745 stable ischaemic heart disease (SIHD) patients were included. At two years, rates of the co-primary efficacy endpoint, a composite of death, myocardial infarction, stroke or urgent target vessel revascularisation, were 7.94% in the experimental and 9.68% in the control group (RR 0.82, 95% CI: 0.66-1.01) among ACS patients and 6.31% in the experimental and 7.14% in the control group (RR 0.89, 95% CI: 0.69-1.13) among SIHD patients (p(int)=0.63). Trends for lower and higher risk of BARC 3 or 5 bleeding with the experimental strategy in ACS (2.27% vs 3.00%, RR 0.76, 95% CI: 0.51-1.12) and SIHD (2.70% vs 1.96%, RR 1.39, 95% CI: 0.91-2.12) patients, respectively, were observed with significant interaction testing (p(int)=0.039). A net clinical benefit endpoint, the composite of both co-primary study endpoints, favoured the experimental treatment among ACS patients only. Conclusions: Ticagrelor monotherapy after one-month DAPT provided consistent treatment effects on ischaemic endpoints in patients with or without ACS but only the former experienced a net clinical benefit.
Document URI: http://hdl.handle.net/1942/34481
ISSN: 1774-024X
e-ISSN: 1969-6213
DOI: 10.4244/EIJ-D-20-00145
ISI #: WOS:000582258100001
Category: A1
Type: Journal Contribution
Appears in Collections:Research publications

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