Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority Trial
DC Field | Value | Language |
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dc.contributor.author | Hong, Sung-Jin | - |
dc.contributor.author | Lee, Seung-Jun | - |
dc.contributor.author | Suh, Yongsung | - |
dc.contributor.author | Yun, Kyeong Ho | - |
dc.contributor.author | Kang, Tae Soo | - |
dc.contributor.author | Shin, Sanghoon | - |
dc.contributor.author | Kwon, Sung Woo | - |
dc.contributor.author | Lee, Jun-Won | - |
dc.contributor.author | Cho, Deok-Kyu | - |
dc.contributor.author | Park, Jong-Kwan | - |
dc.contributor.author | Bae, Jang-Whan | - |
dc.contributor.author | Kang, Woong Cheol | - |
dc.contributor.author | Kim, Seunghwan | - |
dc.contributor.author | Lee, Yong-Joon | - |
dc.contributor.author | Ahn, Chul-Min | - |
dc.contributor.author | Kim, Jung-Sun | - |
dc.contributor.author | Kim, Byeong-Keuk | - |
dc.contributor.author | Ko, Young-Guk | - |
dc.contributor.author | Choi, Donghoon | - |
dc.contributor.author | Jang, Yangsoo | - |
dc.contributor.author | Hong, Myeong-Ki | - |
dc.date.accessioned | 2024-04-04T12:30:17Z | - |
dc.date.available | 2024-04-04T12:30:17Z | - |
dc.date.issued | 2024-02 | - |
dc.identifier.issn | 0009-7322 | - |
dc.identifier.issn | 1524-4539 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/90878 | - |
dc.description.abstract | BACKGROUND: Stopping aspirin within 1 month after implantation of a drug-eluting stent for ticagrelor monotherapy has not been exclusively evaluated for patients with acute coronary syndrome. The aim of this study was to investigate whether ticagrelor monotherapy after <1 month of dual antiplatelet therapy (DAPT) is noninferior to 12 months of ticagrelor-based DAPT for adverse cardiovascular and bleeding events in patients with acute coronary syndrome. METHODS: In this randomized, open-label, noninferiority trial, 2850 patients with acute coronary syndrome who underwent drug-eluting stent implantation at 24 centers in South Korea were randomly assigned (1:1) to receive either ticagrelor monotherapy (90 mg twice daily) after <1 month of DAPT (n=1426) or 12 months of ticagrelor-based DAPT (n=1424) between April 24, 2019, and May 31, 2022. The primary end point was the net clinical benefit as a composite of all-cause death, myocardial infarction, definite or probable stent thrombosis, stroke, and major bleeding at 1 year after the index procedure in the intention-to-treat population. Key secondary end points were the individual components of the primary end point. RESULTS: Among 2850 patients who were randomized (mean age, 61 years; 40% ST-segment-elevation myocardial infarction), 2823 (99.0%) completed the trial. Aspirin was discontinued at a median of 16 days (interquartile range, 12-25 days) in the group receiving ticagrelor monotherapy after <1 month of DAPT. The primary end point occurred in 40 patients (2.8%) in the group receiving ticagrelor monotherapy after <1-month DAPT, and in 73 patients (5.2%) in the ticagrelor-based 12-month DAPT group (hazard ratio, 0.54 [95% CI, 0.37-0.80]; P<0.001 for noninferiority; P=0.002 for superiority). This finding was consistent in the per-protocol population as a sensitivity analysis. The occurrence of major bleeding was significantly lower in the ticagrelor monotherapy after <1-month DAPT group compared with the 12-month DAPT group (1.2% versus 3.4%; hazard ratio, 0.35 [95% CI, 0.20-0.61]; P<0.001). CONCLUSIONS: This study provides evidence that stopping aspirin within 1 month for ticagrelor monotherapy is both noninferior and superior to 12-month DAPT for the 1-year composite outcome of death, myocardial infarction, stent thrombosis, stroke, and major bleeding, primarily because of a significant reduction in major bleeding, among patients with acute coronary syndrome receiving drug-eluting stent implantation. Low event rates, which may suggest enrollment of relatively non-high-risk patients, should be considered in interpreting the trial. REGISTRATION:URL: https://www.clinicaltrials.gov; Unique identifier: NCT03797651. | - |
dc.format.extent | 12 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | - |
dc.title | Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority Trial | - |
dc.type | Article | - |
dc.identifier.wosid | 001167123800004 | - |
dc.identifier.doi | 10.1161/CIRCULATIONAHA.123.066943 | - |
dc.identifier.bibliographicCitation | CIRCULATION, v.149, no.8, pp 562 - 573 | - |
dc.description.isOpenAccess | N | - |
dc.identifier.scopusid | 2-s2.0-85179695121 | - |
dc.citation.endPage | 573 | - |
dc.citation.startPage | 562 | - |
dc.citation.title | CIRCULATION | - |
dc.citation.volume | 149 | - |
dc.citation.number | 8 | - |
dc.type.docType | Article | - |
dc.publisher.location | 미국 | - |
dc.subject.keywordAuthor | acute coronary syndrome | - |
dc.subject.keywordAuthor | antiplatelet agent | - |
dc.subject.keywordAuthor | aspirin | - |
dc.subject.keywordAuthor | drug-eluting stents | - |
dc.subject.keywordPlus | DUAL ANTIPLATELET THERAPY | - |
dc.subject.keywordPlus | DRUG-ELUTING STENTS | - |
dc.subject.keywordPlus | ARTERY-DISEASE | - |
dc.subject.keywordPlus | CARDIOVASCULAR EVENTS | - |
dc.subject.keywordPlus | FOCUSED UPDATE | - |
dc.subject.keywordPlus | INTERVENTION | - |
dc.subject.keywordPlus | CLOPIDOGREL | - |
dc.subject.keywordPlus | DEFINITIONS | - |
dc.subject.keywordPlus | DIAGNOSIS | - |
dc.subject.keywordPlus | EFFICACY | - |
dc.relation.journalResearchArea | Cardiovascular System & Cardiology | - |
dc.relation.journalWebOfScienceCategory | Cardiac & Cardiovascular Systems | - |
dc.relation.journalWebOfScienceCategory | Peripheral Vascular Disease | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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