Ticagrelor monotherapy in patients with chronic kidney disease undergoing percutaneous coronary intervention: TWILIGHT-CKD
European Heart Journal Aug 26, 2021
Stefanini GG, Briguori C, Cao D, et al. - Ticagrelor monotherapy, in comparison to ticagrelor plus aspirin, resulted in decreased risk of bleeding without a significant increase in ischaemic events in chronic kidney disease (CKD) patients receiving percutaneous coronary intervention.
This is a prespecified subanalysis of the TWILIGHT trial.
Patients receiving drug-eluting stent implantation who met at least one clinical and one angiographic high-risk criterion were included.
After a 3-month span of ticagrelor plus aspirin, event-free patients were randomized to aspirin or placebo on top of ticagrelor for an additional 12 months.
Bleeding Academic Research Consortium type 2, 3, or 5 bleeding was decreased with ticagrelor plus placebo, vs ticagrelor plus aspirin, in both patients with and without CKD; however, greater absolute risk reduction was achieved in the former group.
Regardless of presence or absence of CKD, no significant difference in rates of death, myocardial infarction, or stroke was found between the two randomized groups.
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