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New insights from the TWILIGHT trial confirmed that ticagrelor monotherapy after three months of ticagrelor plus aspirin was related to related charges of recurrent coronary revascularization, main opposed cardiac and cerebrovascular occasions (MACCE) and a decrease threat of web opposed medical occasions (NACE) in contrast with duel antiplatelet remedy (DAPT). The outcomes from the randomized management trial of greater than 7,000 sufferers had been introduced in the present day as late-breaking medical analysis on the Society for Cardiovascular Angiography & Interventions (SCAI) 2023 Scientific Classes.
Regardless of advances in percutaneous coronary intervention (PCI) methods, units 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 had been event-free and adherent to a ticagrelor-based DAPT for 3 months after PCI had been randomized to ticagrelor plus aspirin or ticagrelor plus placebo for 12 further months. The first endpoint was repeat revascularization resulting from recurrent or persistent symptomatic myocardial ischemia. Secondary endpoints included goal lesion revascularization (TLR), goal vessel revascularization (TVR) and main opposed cardiac and cerebrovascular occasions (MACCE) and web opposed medical occasions (NACE). All endpoints had been adjudicated and assessed at 12 months after randomization within the per-protocol inhabitants.
Amongst 7,039 sufferers, ticagrelor monotherapy and ticagrelor plus aspirin had been related to an identical 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 loss of life, myocardial infarction or stroke (aHR 2.92, 95% CI 1.82 – 4.67).
In high-risk PCI sufferers, it’s important to reduce the incidence of repeat revascularization. The findings introduced in the present day from the TWILIGHT trial present a better understanding of the impression of DAPT and ticagrelor monotherapy following PCI for the medical neighborhood.”
Usman Baber, M.D., Affiliate Professor of Drugs on the College of Oklahoma Well being Sciences Middle, and lead writer of the examine
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