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双重抗血小板治疗持续时间

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Bleeding-Related Deaths in Relation to the Duration of Dual-Antiplatelet Therapy After Coronary Stenting Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study Mortality Following Cardiovascular and Bleeding Events Occurring Beyond 1 Year After Coronary Stenting - A Secondary Analysis of the Dual Antiplatelet Therapy (DAPT) Study Risk of Early Adverse Events After Clopidogrel Discontinuation in Patients Undergoing Short-Term Dual Antiplatelet Therapy: An Individual Participant Data Analysis Low-Dose Aspirin Discontinuation and Risk of Cardiovascular Events: A Swedish Nationwide, Population-Based Cohort Study Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation Characterization of the Average Daily Ischemic and Bleeding Risk After Primary PCI for STEMI Patterns and associations between DAPT cessation and 2-year clinical outcomes in left main/proximal LAD versus other PCI: Results from the Patterns of Non-Adherence to Dual Antiplatelet Therapy in Stented Patients (PARIS) registry State of the art: duration of dual antiplatelet therapy after percutaneous coronary intervention and coronary stent implantation - past, present and future perspectives. Causes, Timing, and Impact of Dual Antiplatelet Therapy Interruption for Surgery (from the Patterns of Non-adherence to Anti-platelet Regimens In Stented Patients Registry)
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Clinical Trial2020 Jul 28;EIJ-D-20-00187.

JOURNAL：Eurointervention. Article Link

A Prospective, Multicenter, Randomized, Open-label Trial to Compare Efficacy and Safety of Clopidogrel vs. Ticagrelor in Stabilized Patients with Acute Myocardial Infarction after Percutan eous Coronary Intervention: rationale and design of the TALOS-AMI trial

M-W Park, CJ Kim, K Chang et al. Keywords: clopidogrel vs. ticagrelor; AMI; BARC criteria from 1 to 12 months after the index PCI

ABSTRACT

AIMS - In patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), the risk of ischemic complications is highest in early phase (during the first 30days), while most bleeding events predominantly occur during maintenance phase of treatment (after the first 30days). Data on the de-escalating dual antiplatelet therapy of switching from ticagrelor to clopidogrel in stabilized AMI patients are limited.


METHODS AND RESULTS - The TALOS-AMI is a, multicenter, randomized, open-label study enrolling 2590 AMI patients with no adverse events during the first month after the index PCI. One month after the index PCI, eligible patients are randomly assigned either to the 1) aspirin 100 mg plus clopidogrel 75mg daily or 2) aspirin 100 mg plus ticagrelor 90 mg twice daily in a 1:1 ratio. The primary endpoint is a composite of cardiovascular death, MI, stroke, and bleeding type 2, 3 or 5 according to Bleeding Academic Research Consortium (BARC) criteria from 1 to 12 months after the index PCI.


CONCLUSIONS - The TALOS-AMI trial is the first large-scale, multicenter, randomized study exploring the efficacy and safety of the de-escalating antiplatelet therapy that switches ticagrelor to clopidogrel in stabilized AMI patients undergoing PCI.

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