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Ticagrelor With or Without Aspirin in Chinese Patients Undergoing Percutaneous Coronary Intervention: A TWILIGHT China Substudy.

Publication ,  Journal Article
Han, Y; Claessen, BE; Chen, S-L; Chunguang, Q; Zhou, Y; Xu, Y; Hailong, L; Chen, J; Qiang, W; Zhang, R; Luo, S; Li, Y; Zhu, J; Zhao, X ...
Published in: Circ Cardiovasc Interv
April 2022

BACKGROUND: The risk/benefit tradeoff of dual antiplatelet therapy after percutaneous coronary intervention may vary in East Asian patients as compared with their non-East Asian counterparts. METHODS: The double-blind, placebo-controlled, randomized TWILIGHT trial (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention) enrolled patients undergoing high-risk percutaneous coronary intervention. After 3 months of treatment with ticagrelor plus aspirin, event-free and adherent patients remained on ticagrelor and were randomly assigned to receive aspirin or placebo for 1 year. The primary end point was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding; the key secondary end point was the first occurrence of death from any cause, nonfatal myocardial infarction, or nonfatal stroke. RESULTS: Of 9006 enrolled and 7119 randomized patients in TWILIGHT, 1169 patients (13.0%) were enrolled at 27 Chinese sites in this prespecified substudy, of whom 1028 (14.4%) patients were randomized after 3 months. The incidence of the primary end point was 6.2% in the ticagrelor+aspirin group versus 3.5% in the ticagrelor+placebo group between randomization and 1 year (hazard ratio, 0.56 [95% CI, 0.31-0.99]; P=0.048). The key secondary end point occurred in 3.4% of patients in the ticagrelor+aspirin group versus 2.4% in the ticagrelor+placebo group (hazard ratio, 0.70 [95% CI, 0.33-1.46]; P=0.34). There was no interaction between the region of randomization (China versus the rest of the world) and randomized treatment assignment in terms of the primary or key secondary end points. CONCLUSIONS: Ticagrelor monotherapy significantly reduced clinically relevant bleeding without increasing ischemic events as compared with ticagrelor plus aspirin in Chinese patients undergoing high-risk percutaneous coronary intervention. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02270242.

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Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

April 2022

Volume

15

Issue

4

Start / End Page

e009495

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ticagrelor
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Humans
  • Hemorrhage
  • Drug Therapy, Combination
  • Cardiovascular System & Hematology
  • Aspirin
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Han, Y., Claessen, B. E., Chen, S.-L., Chunguang, Q., Zhou, Y., Xu, Y., … Mehran, R. (2022). Ticagrelor With or Without Aspirin in Chinese Patients Undergoing Percutaneous Coronary Intervention: A TWILIGHT China Substudy. Circ Cardiovasc Interv, 15(4), e009495. https://doi.org/10.1161/CIRCINTERVENTIONS.120.009495
Han, Yaling, Bimmer E. Claessen, Shao-Liang Chen, Qiu Chunguang, Yujie Zhou, Yawei Xu, Lin Hailong, et al. “Ticagrelor With or Without Aspirin in Chinese Patients Undergoing Percutaneous Coronary Intervention: A TWILIGHT China Substudy.Circ Cardiovasc Interv 15, no. 4 (April 2022): e009495. https://doi.org/10.1161/CIRCINTERVENTIONS.120.009495.
Han Y, Claessen BE, Chen S-L, Chunguang Q, Zhou Y, Xu Y, et al. Ticagrelor With or Without Aspirin in Chinese Patients Undergoing Percutaneous Coronary Intervention: A TWILIGHT China Substudy. Circ Cardiovasc Interv. 2022 Apr;15(4):e009495.
Han, Yaling, et al. “Ticagrelor With or Without Aspirin in Chinese Patients Undergoing Percutaneous Coronary Intervention: A TWILIGHT China Substudy.Circ Cardiovasc Interv, vol. 15, no. 4, Apr. 2022, p. e009495. Pubmed, doi:10.1161/CIRCINTERVENTIONS.120.009495.
Han Y, Claessen BE, Chen S-L, Chunguang Q, Zhou Y, Xu Y, Hailong L, Chen J, Qiang W, Zhang R, Luo S, Li Y, Zhu J, Zhao X, Cheng X, Wang J, Su X, Tao J, Sun Y, Wang G, Bian L, Goel R, Sartori S, Zhang Z, Angiolillo DJ, Cohen DJ, Gibson CM, Kastrati A, Krucoff M, Mehta SR, Ohman EM, Steg PG, Liu Y, Dangas G, Sharma S, Baber U, Mehran R. Ticagrelor With or Without Aspirin in Chinese Patients Undergoing Percutaneous Coronary Intervention: A TWILIGHT China Substudy. Circ Cardiovasc Interv. 2022 Apr;15(4):e009495.

Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

April 2022

Volume

15

Issue

4

Start / End Page

e009495

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ticagrelor
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Humans
  • Hemorrhage
  • Drug Therapy, Combination
  • Cardiovascular System & Hematology
  • Aspirin
  • 3201 Cardiovascular medicine and haematology