New insights from the TWILIGHT trial confirmed that ticagrelor monotherapy after three months of ticagrelor plus aspirin was related to comparable charges of recurrent coronary revascularization, main hostile cardiac and cerebrovascular occasions (MACCE) and a decrease threat of web hostile medical occasions (NACE) in contrast with duel antiplatelet remedy (DAPT). The outcomes from the randomized management trial of greater than 7,000 sufferers have been offered right now as late-breaking medical analysis on the Society for Cardiovascular Angiography & Interventions (SCAI) 2023 Scientific Periods.

Regardless of advances in percutaneous coronary intervention (PCI) methods, gadgets and secondary prevention, repeat revascularization stays a priority and is related to elevated morbidity, hospitalization and healthcare prices.

Within the TWILIGHT trial, high-risk sufferers who have been event-free and adherent to a ticagrelor-based DAPT for 3 months after PCI have been randomized to ticagrelor plus aspirin or ticagrelor plus placebo for 12 further months. The first endpoint was repeat revascularization as a consequence of recurrent or persistent symptomatic myocardial ischemia. Secondary endpoints included goal lesion revascularization (TLR), goal vessel revascularization (TVR) and main hostile cardiac and cerebrovascular occasions (MACCE) and web hostile medical occasions (NACE). All endpoints have been adjudicated and assessed at 12 months after randomization within the per-protocol inhabitants.

Amongst 7,039 sufferers, ticagrelor monotherapy and ticagrelor plus aspirin have been related to the same threat of repeat revascularization (7.1% vs 6.6%, HR 1.09, 95% CI 0.90-1.30), TLR, TVR and MACCE, whereas NACE was decrease with ticagrelor monotherapy. The outcomes additionally confirmed that clinically-driven revascularization was related to an extra threat for subsequent demise, myocardial infarction or stroke (aHR 2.92, 95% CI 1.82 – 4.67).

In high-risk PCI sufferers, it is important to minimize the prevalence of repeat revascularization. The findings offered right now from the TWILIGHT trial present a higher understanding of the influence of DAPT and ticagrelor monotherapy following PCI for the medical group.”

Usman Baber, M.D., Affiliate Professor of Medication on the College of Oklahoma Well being Sciences Heart, and lead creator of the examine