Kim C, et al. - In the TICO randomized open-label trial, researchers examine the superiority of ticagrelor monotherapy following 3-month dual-antiplatelet therapy (DAPT) to 12-month ticagrelor-based DAPT in terms of net adverse clinical events (NACE) including efficacy and safety in acute coronary syndrome (ACS) patients treated with ultrathin bioresorbable polymer sirolimus-eluting stents (BP-SES). They will perform randomization of patients undergoing BP-SES implantation for ACS treatment in a 1:1 fashion to the ticagrelor monotherapy group after 3-month DAPT; or the 12-month DAPT group. NACE within 12 months of percutaneous coronary intervention comprised the primary endpoint; it included major adverse cardiac and cerebrovascular events (MACCE) plus major bleeding as defined by Thrombolysis in Myocardial Infarction. The composite of all-cause death, myocardial infarction, stent thrombosis, stroke, and target vessel revascularization was included in MACCE. Each component of the primary endpoint was assessed as the secondary endpoints. This trial may afford novel insights concerning the necessity for adjusted use of DAPT for rebalancing risk–benefit in current practice and changing from the conventional concept of aspirin maintenance to a ticagrelor-based regimen in the management of ACS.