Antiplatelet Therapy After PCI: The Art and Science of De-Escalation

HomeCirculationVol. 149, No. 8Antiplatelet Therapy After PCI: The Art and Science of De-Escalation No AccessEditorialRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplemental MaterialNo AccessEditorialRequest AccessFull TextAntiplatelet Therapy After PCI: The Art and Science of De-Escalation Robert F. Storey Robert F. StoreyRobert F. Storey Correspondence to: Robert F. Storey, MD, DM, Cardiovascular Research Unit, Division of Clinical Medicine, University of Sheffield, Beech Hill Rd, Sheffield, S10 2RX, United Kingdom. Email E-mail Address: [email protected] https://orcid.org/0000-0002-6677-6229 Cardiovascular Research Unit, Division of Clinical Medicine, University of Sheffield, United Kingdom (R.F.S.). National Institute for Health and Care Research Sheffield Biomedical Research Centre, Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield, United Kingdom (R.F.S.). Originally published20 Feb 2024https://doi.org/10.1161/CIRCULATIONAHA.123.067767Circulation. 2024;149:601–604This article is a commentary on the followingSafety and Efficacy of Ticagrelor Monotherapy in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: An Individual Patient Data Meta-Analysis of TWILIGHT and TICO Randomized TrialsStopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority TrialAn Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting: STOPDAPT-3 Randomized TrialFootnotesThe podcast and transcript are available as Supplemental Material at https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.123.067767.The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.For Disclosures, see page 603.Circulation is available at www.ahajournals.org/journal/circCorrespondence to: Robert F. Storey, MD, DM, Cardiovascular Research Unit, Division of Clinical Medicine, University of Sheffield, Beech Hill Rd, Sheffield, S10 2RX, United Kingdom. Email r.f.storey@sheffield.ac.ukREFERENCES1. Baber U, Jang Y, Oliva A, Cao D, Vogel B, Dangas G, Sartori S, Spirito A, Smith KF, Branca M, et al. Safety and efficacy of ticagrelor monotherapy in patients with acute coronary syndromes undergoing percutaneous coronary intervention: an individual patient data meta-analysis of TWILIGHT and TICO randomized trials.Circulation. 2024; 149:574–584. doi: 10.1161/CIRCULATIONAHA.123.067283LinkGoogle Scholar2. Hong S-J, Lee S-J, Suh Y, Yun KH, Kang TS, Shin S, Kwon SW, Lee J-W, Cho D-K, Park J-K, et al. Stopping aspirin within 1 month after stenting for ticagrelor monotherapy in acute coronary syndrome: the T-PASS randomized noninferiority trial.Circulation. 2024; 149:562–573. doi: 10.1161/CIRCULATIONAHA.123.066943LinkGoogle Scholar3. 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Platelet inhibition with ticagrelor 60 mg versus 90 mg twice daily in the PEGASUS-TIMI 54 trial.J Am Coll Cardiol. 2016; 67:1145–1154. doi: 10.1016/j.jacc.2015.12.062CrossrefMedlineGoogle Scholar8. Orme RC, Parker WA, Thomas MR, Judge HM, Baster K, Sumaya W, Morgan KP, McMellon HC, Richardson JD, Grech ED, et al. Study of two dose regimens of ticagrelor compared with clopidogrel in patients undergoing percutaneous coronary intervention for stable coronary artery disease (STEEL-PCI).Circulation. 2019; 138:1290–1300. doi: 10.1161/CIRCULATIONAHA.118.034790LinkGoogle Scholar9. Watanabe H, Domei T, Morimoto T, Natsuaki M, Shiomi H, Toyota T, Ohya M, Suwa S, Takagi K, Nanasato M, et al. Effect of 1-month dual antiplatelet therapy followed by clopidogrel vs 12-month dual antiplatelet therapy on cardiovascular and bleeding events in patients receiving PCI: the STOPDAPT-2 randomized clinical trial.JAMA. 2019; 321:2414–2427. doi: 10.1001/jama.2019.8145CrossrefMedlineGoogle Scholar10. 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Relationship between degree of P2Y12 receptor blockade and inhibition of P2Y12-mediated platelet function.Thromb Haemost. 2010; 103:1210–1217. doi: 10.1160/TH09-11-0770CrossrefMedlineGoogle Scholar14. Bonaca MP, Im KA, Magnani G, Bansilal S, Dellborg M, Storey RF, Bhatt DL, Steg PG, Cohen M, Johanson P, et al. Patient selection for long-term secondary prevention with ticagrelor: insights from PEGASUS-TIMI 54.Eur Heart J. 2022; 43:5037–5044. doi: 10.1093/eurheartj/ehac402CrossrefMedlineGoogle Scholar15. Storey RF. The long journey of individualizing antiplatelet therapy after acute coronary syndromes.Eur Heart J. 2020; 41:3546–3548. doi: 10.1093/eurheartj/ehaa644CrossrefMedlineGoogle Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesSafety and Efficacy of Ticagrelor Monotherapy in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: An Individual Patient Data Meta-Analysis of TWILIGHT and TICO Randomized TrialsUsman Baber, et al. Circulation. 2024;149:574-584Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority TrialSung-Jin Hong, et al. Circulation. 2024;149:562-573An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting: STOPDAPT-3 Randomized TrialMasahiro Natsuaki, et al. Circulation. 2024;149:585-600 February 20, 2024Vol 149, Issue 8 Advertisement Circulation on the Run: February 20, 2024 February 20, 2024 Article InformationMetrics © 2024 American Heart Association, Inc.https://doi.org/10.1161/CIRCULATIONAHA.123.067767PMID: 38377261 Originally publishedFebruary 20, 2024 KeywordsEditorialsaspirinbleedingpercutaneous coronary interventionthrombosisticagrelorPDF download Advertisement SubjectsPercutaneous Coronary InterventionPharmacologyStentTreatment