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Pharmacodynamic comparison of ticagrelor monotherapy vs ticagrelor and aspirin in patients after percutaneous coronary intervention: The TEMPLATE (Ticagrelor Monotherapy and Platelet Reactivity) randomized controlled trial

Journal of the American Heart Association Dec 27, 2020

Johnson TW, Baos S, Collett L, et al. - By performing a single‐center parallel group, open label, randomized controlled trial, researchers examined disparities in platelet inhibition during ticagrelor monotherapy (TIC) or dual therapy with ticagrelor and aspirin (TIC+ASP) in patients following percutaneous coronary intervention (PCI) employing a comprehensive panel of functional tests. A total of 110 participants were randomly assigned to receive either TIC (n = 55) or TIC+ASP (n = 55) for 4 weeks. Platelet aggregation response with 10 μmol/L thrombin receptor activation peptide‐6 was the primary outcome. According to findings, PCI patients demonstrated similar levels of inhibition of most platelet activation pathways with TIC vs dual therapy with TIC + ASP. However, incomplete inhibition of glycoprotein VI (collagen) receptor‐mediated platelet activation was suggested by the observed greater aggregation response with collagen related peptide during TIC. This disparity in pharmacodynamic response to anti‐platelet medication was suggested to be a likely contributor to the lower bleeding rates noted with TIC vs dual antiplatelet therapy in recent clinical trials.

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