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双重抗血小板治疗持续时间

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Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial Dual Antiplatelet Therapy Duration: Reconciling the Inconsistencies Ticagrelor with or without Aspirin in High-Risk Patients after PCI Derivation, Validation, and Prognostic Utility of a Prediction Rule for Nonresponse to Clopidogrel: The ABCD-GENE Score Major Bleeding Rates in Atrial Fibrillation Patients on Single, Dual, or Triple Antithrombotic Therapy Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting: a randomized multicenter trial Clopidogrel Pharmacogenetics: State-of-the-Art Review and the TAILOR-PCI Study Clopidogrel or ticagrelor in acute coronary syndrome patients treated with newer-generation drug-eluting stents: CHANGE DAPT Management of Antithrombotic Therapy in Atrial Fibrillation Patients Undergoing PCI: JACC State-of-the-Art Review Study of Two Dose Regimens of Ticagrelor Compared with Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention for Stable Coronary Artery Disease (STEEL-PCI)
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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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