Why is this study important?

• Assesses the results of ticagrelor monotherapy at one year, after three months of initial DAPT (dual antiplatelet therapy) in high-risk PCI (percutaneous coronary intervention) patients

What question was this study supposed to answer?

• Is ticagrelor monotherapy vs. DAPT sufficient to reduce repeat revascularization (the primary endpoint), with PCI or CABG (coronary artery bypass grafting) for recurrent or persistent symptomatic ischemia
• Secondary endpoints were also reported

What did the study show?

• Post hoc analysis of 6,759 patients in the TWILIGHT trial
• High risk PCI patients were enrolled
• Ticagrelor monotherapy with initial 3 month of DAPT (Aspirin and Ticagrelor) was associated with:

• Similar rates of repeat revascularization (7.1% vs 6.7%, HR 1.07, 95% CI 0.89-1.29)-the primary end point
• Secondary endpoints demonstrated similar rates of:
  • Major adverse cardiac and cerebrovascular events (MACCE)
  • Target lesion revascularization (TLR)
  • Target vessel revascularization (TVR)
• A benefit was seen in:
• Effective reduction of BARC, 2,3,5 bleeding
• Net adverse cardiac events (NACE)

Conclusion:

In high-risk PCI patients, Ticagrelor monotherapy after three months of initial DAPT, demonstrates safety without increased risk of repeat revascularization at 12 months.