TICO-STEMI: Ticagrelor Monotherapy vs. Ticagrelor With Aspirin in STEMI

STEMI patients treated with ultrathin bioresorbable polymersirolimus-eluting stents and receiving ticagrelor monotherapy after three-month dual antiplatelet therapy (DAPT) had reduced risk of major bleeding compared with patients who received ticagrelor-based 12-month DAPT, according to findings from the TICO-STEMI trial presented Oct. 14 during TCT 2020.

Byeong-Keuk Kim, MD, PhD, et al., used a prespecified cohort of 1,103 STEMI patients from 38 centers in South Korea who were enrolled in the broader TICO trial. Stratified randomization was performed based on the presence of STEMI, with 546 patients assigned to receive ticagrelor monotherapy after three-month DAPT and 557 patients assigned to receive ticagrelor-based 12-month DAPT.

Results highlighted that major bleeding risk was reduced in the ticagrelor monotherapy group and there were no significant differences observed between the two treatment groups in terms of major adverse cardiac and cerebrovascular events.

“This is the first report assessing the feasibility of the ticagrelor monotherapy after short-term DAPT for STEMI patients with [drug-eluting stent],” Kim said. However, he noted that “care should be taken in applying these results to the overall STEMI population, especially those at high risk for ischemia.”

Keywords: TCT20, Transcatheter Cardiovascular Therapeutics, Aspirin, ST Elevation Myocardial Infarction, Percutaneous Coronary Intervention, Diabetes Mellitus

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