이달의 kcj Hot Article / 2025년 9월
Ticagrelor Monotherapy vs. Ticagrelor With Aspirin in Bleeding and Cardiovascular Events in Acute Coronary Syndrome Patients According to Renal Function: The Subanalysis From the TICO Trial |
| 저자 |
Ji Hyun Lee, MD,1
Hyeonju Jeong, MD,1
Eui-Seock Hwang, MD,1
Sung-Jin Hong, MD,2
Chul-Min Ahn, MD,2
Jung-Sun Kim, MD,2
Byeong-Keuk Kim, MD,2
Young-Guk Ko, MD,2
Donghoon Choi, MD,2
Myeong-Ki Hong, MD,2
Yangsoo Jang, MD,3
Yun-Hyeong Cho, MD, PhD,1
and Yongsung Suh, MD1 |
| 소속 |
1Division of Cardiology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
2Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
3Division of Cardiology, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea. |
Background and ObjectivesTicagrelor monotherapy after short-term dual-antiplatelet therapy (DAPT) has not been established in chronic kidney disease (CKD) patients. This study evaluated the effects of ticagrelor monotherapy after 3-month of DAPT on renal function in acute coronary syndrome patients. MethodsFrom the TICO trial, the primary outcome was a composite of net adverse clinical events (NACEs), defined as a composite of major bleeding and major adverse cardiovascular and cerebrovascular events (MACCEs). The secondary outcomes were thrombolysis in myocardial infarction (TIMI) major or minor bleeding and MACCE. ResultsAmong patients without CKD (n=2,436), ticagrelor monotherapy after 3 months of DAPT had a lower rate of NACE (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.21–0.78; p=0.007) and TIMI bleeding (HR, 0.86; 95% CI, 0.19–0.81; p=0.011) than those of ticagrelor-based 12-month DAPT. Among CKD patients receiving ticagrelor monotherapy, lower risk of NACE (HR, 0.45; 95% CI, 0.20–1.02; p=0.055) and bleeding (HR, 0.20; 95% CI, 0.06–0.68; p=0.009) were observed. Otherwise, ticagrelor monotherapy was not significantly associated with an increased MACCE risk in those without CKD (HR, 0.62; 95% CI, 0.30–1.27; p=0.192) or with CKD (HR, 0.55; 95% CI, 0.21–1.48; p=0.237), versus 12-month DAPT. ConclusionsRegardless of renal function, ticagrelor monotherapy after 3 months of DAPT resulted in a reduced risk of not only NACE but also major or minor bleeding at 1 year compared with ticagrelor-based 12-month DAPT. Irrespective of renal function status, however, the MACCE risk was not significantly different between the two strategies.
|
| 첨부파일1 |
 KCJ-24-232 GA.JPG (다운 22회) |
