You are currently viewing The Twilight Trial

The Twilight Trial

EBC - ON DEMAND

The Twilight Trial

European Bifurcation Club 2019, EBC 2019 – Barcelona, Spain

NEWS 3

The Twilight Trial: Ticagrelor with or without aspirin in high-risk patients after PCI

Author: Vladimir Dzavik, MD, PhD, Toronto General Hospital, Canada

 

TRIAL HYPOTHESIS

In patients undergoing PCI who are at high risk for ischemic or hemorrhagic complications and who have completed a 3-month course of dual antiplatelet therapy with ticagrelor plus aspirin, continued treatment with ticagrelor monotherapy would be superior to ticagrelor plus aspirin with respect to clinically relevant bleeding and would not lead to ischemic harm.

TRIAL OBJECTIVES

Primary Objective:

To determine the impact of SAPT (ticagrelor monotherapy) versus DAPT (ticagrelor plus aspirin) for 12 months in reducing clinically relevant bleeding (BARC 2, 3 or 5) among high-risk patients who have undergone successful PCI.

Secondary Objective:

To determine the impact of SAPT (ticagrelor monotherapy) versus DAPT (ticagrelor plus aspirin) for 12 months on major ischemic adverse events (all-cause death, non-fatal MI or stroke) among high-risk patients who have undergone successful PCI.

CONCLUSION

In high-risk patients who underwent PCI and were treated with ticagrelor and aspirin for 3 months without any major adverse (bleeding or ischemic) events, an antiplatelet strategy of continuing ticagrelor monotherapy resulted in:

  • substantially less bleeding than ticagrelor plus aspirin
  • without increasing ischemic events over a period of 1 year

 

Download here

Leave a Reply