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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 Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention Ticagrelor With or Without Aspirin After PCI: The TWILIGHT Platelet Substudy Benefit-risk profile of extended dual antiplatelet therapy beyond 1 year in patients with high risk of ischemic or bleeding events after PCI Aspirin-Free Prasugrel Monotherapy Following Coronary Artery Stenting in Patients With Stable CAD: The ASET Pilot Study Efficacy and Safety of Ticagrelor Monotherapy in Patients Undergoing Multivessel PCI Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial Sex-Based Outcomes in Patients With a High Bleeding Risk After Percutaneous Coronary Intervention and 1-Month Dual Antiplatelet Therapy: A Secondary Analysis of the LEADERS FREE Randomized Clinical Trial
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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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