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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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