한빛사논문
- 조회207
한양대학교 의과대학, 명지병원
Yong-Joon Lee1†, Sanghoon Shin2†, Sung Woo Kwon3†, Yongsung Suh4*, Kyeong Ho Yun5, Tae Soo Kang6, Jun-Won Lee7, Deok-Kyu Cho8, Jong-Kwan Park9, Jang-Whan Bae10, Woong Cheol Kang11, Seunghwan Kim12, Seung-Jun Lee1, Sung-Jin Hong1, Chul-Min Ahn1, Jung-Sun Kim1, Byeong-Keuk Kim1, Young-Guk Ko1, Donghoon Choi1, Yangsoo Jang13, and Myeong-Ki Hong1*
1Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea;
2Department of Cardiology, Ewha Womans University College of Medicine Seoul Hospital, Seoul, Korea;
3Department of Cardiology, Inha University Hospital, Incheon, Korea;
4Myongji Hospital, Hanyang University College of Medicine, 55 Hwasu-ro 14 beon-gil, Deokyang-gu, 10475 Goyang, Korea;
5Department of Cardiology, Wonkwang University Hospital, Iksan, Korea;
6Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea;
7Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea;
8Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea;
9Department of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea;
10Department of Cardiology, Chungbuk National University College of Medicine, Cheongju, Korea;
11Department of Cardiology, Gachon University Gil Medical Center, Incheon, Korea;
12Department of Cardiology, Inje University Haeundae Paik Hospital, Busan, Korea; and
13Department of Cardiology, CHA University College of Medicine, Seongnam, Korea
Yong-Joon Lee, Sanghoon Shin and Sung Woo Kwon contributed equally to this work.
*Corresponding authors: Yongsung Suh, Myeong-Ki Hong
Abstract
Background and aims: In patients with acute coronary syndrome (ACS), dual antiplatelet therapy (DAPT) with aspirin and a potent P2Y12 inhibitor is recommended for 12 months after drug-eluting stent (DES) implantation. Monotherapy with a potent P2Y12 inhibitor after short-term DAPT is an attractive option to better balance the risks of ischaemia and bleeding. Therefore, this study evaluated the efficacy and safety of ticagrelor monotherapy after short-term DAPT, especially in patients with ACS.
Methods: Electronic databases were searched from inception to 11 November 2023, and for the primary analysis, individual patient data were pooled from the relevant randomized clinical trials comparing ticagrelor monotherapy after short-term (≤3 months) DAPT with ticagrelor-based 12-month DAPT, exclusively in ACS patients undergoing DES implantation. The co-primary endpoints were ischaemic endpoint (composite of all-cause death, myocardial infarction, or stroke) and bleeding endpoint [Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding] at 1 year.
Results: Individual patient data from two randomized clinical trials including 5906 ACS patients were analysed. At 1 year, the primary ischaemic endpoint did not differ between the ticagrelor monotherapy and ticagrelor-based DAPT groups [1.9% vs. 2.5%; adjusted hazard ratio (HR) 0.79; 95% confidence interval (CI) 0.56-1.13; P = .194]. The incidence of the primary bleeding endpoint was lower in the ticagrelor monotherapy group (2.4% vs. 4.5%; adjusted HR 0.54; 95% CI 0.40-0.72; P < .001). The results were consistent in a secondary aggregate data meta-analysis including the ACS subgroup of additional randomized clinical trials which enrolled patients with ACS as well as chronic coronary syndrome.
Conclusions: In ACS patients undergoing DES implantation, ticagrelor monotherapy after short-term DAPT was associated with less major bleeding without a concomitant increase in ischaemic events compared with ticagrelor-based 12-month DAPT.
논문정보
- Research article
- 2024년 05월 (BRIC 등록일 2024-05-16)
- 국내 연구진
- 의약학 > 응용의학
관련 보도자료
- Bio통신원
- 2024. 05. 24
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