Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention
Open accessAbstract
Background P2Y 12 inhibitor monotherapy with ticagrelor after a brief period of dual antiplatelet therapy can reduce bleeding without increasing ischemic harm after percutaneous coronary intervention (PCI). The impact of this approach among patients with diabetes mellitus (DM) remains unknown. Objectives The purpose of this study was to examine the effect of ticagrelor monotherapy versus ticagrelor plus aspirin among patients with DM undergoing PCI. Methods This was a pre-specified analysis of the DM cohort in the TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk Patients after Coronary Intervention) trial. After 3 months of ticagrelor plus aspirin, patients were maintained on ticagrelor and randomized to aspirin or placebo for 1 year. The primary endpoint was Bleeding Academic Research Consortium 2, 3, or 5 bleeding. The composite ischemic endpoint was all-cause death, myocardial infarction, or stroke. Results Patients with DM comprised 37% (n = 2,620) of the randomized cohort and were characterized by more frequent comorbidities and a higher prevalence of multivessel disease. The incidence of Bleeding Academic Research Consortium 2, 3, or 5 bleeding was 4.5% and 6.7% among patients with DM randomized to ticagrelor plus placebo versus ticagrelor plus aspirin (hazard ratio: 0.65; 95% confidence interval: 0.47 to 0.91; p = 0.012). Ticagrelor monotherapy was not associated with an increase in ischemic events compared with ticagrelor plus aspirin (4.6% vs. 5.9%; hazard rat…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Early aspirin discontinuation compared with continued dual antiplatelet therapy after coronary stenting may reduce the risk of bleeding without a corresponding increase in the risks of mortality and ischemic events, as shown in a prespecified analysis of people with diabetes enrolled in the TWILIGHT trial and a meta-analysis.
“However, early aspirin discontinuation compared with continued dual antiplatelet therapy after coronary stenting may reduce the risk of bleeding without a corresponding increase in the risks of mortality and ischemic events, as shown in a prespecified analysis of people with diabetes enrolled in the TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention) trial”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [203]
No citation lists for this paper
No citation lists for this paper yet — checked again daily.
References 40 · Cited by 87
- Authors
- Angiolillo, D. J., Baber, U., Sartori, S., Briguori, C., Dangas, G., Cohen, D. J., Mehta, S. R., Gibson, C. M., Chandiramani, R., Huber, K., Kornowski, R., Weisz, G., Kunadian, V., Oldroyd, K. G., Ya-Ling, H., Kaul, U., Witzenbichler, B., Dudek, D., Sardella, G., Escaned, J., Sharma, S., Shlofmitz, R. A., Collier, T., Pocock, S., & Mehran, R.
- Affiliations
- University of Florida (US)
- Icahn School of Medicine at Mount Sinai (US)
- Clinica Mediterranea (IT)
- University of Missouri–Kansas City (US)
- Population Health Research Institute (CA)
- Beth Israel Deaconess Medical Center (US)
- Sigmund Freud Privatuniversität Wien (AT)
- Rabin Medical Center (IL)
- Montefiore Medical Center (US)
- Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
- Golden Jubilee National Hospital (GB)
- Batra Hospital and Medical Research Centre (IN)
- Helios Amper-Klinikum Dachau (DE)
- Jagiellonian University (PL)
- Policlinico Umberto I (IT)
- Universidad Complutense de Madrid (ES)
- St. Francis Hospital (US)
- London School of Hygiene & Tropical Medicine (GB)
- ORCID
- Angiolillo, Dominick J.
- Baber, Usman
- Sartori, Samantha
- Briguori, Carlo
- Dangas, George
- Cohen, David J.
- Mehta, Shamir R.
- Gibson, C. Michael
- Chandiramani, Rishi
- Huber, Kurt
- Kornowski, Ran
- Kunadian, Vijay
- Oldroyd, Keith G.
- Kaul, Upendra
- Witzenbichler, Bernhard
- Dudek, Dariusz
- Sardella, Gennaro
- Escaned, Javier
- Sharma, Samin
- Shlofmitz, Richard A.
- Collier, Timothy
- Pocock, Stuart
- Mehran, Roxana
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 75
- Issue
- 19
- Pages
- 2403-2413
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W3013912639
- Cited by
- 87
- References
- 40
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 10 · 2023: 12 · 2022: 19 · 2021: 16 · 2020: 19
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Homo Politicus (Academy of Humanities and Economics in Lodz) (submittedVersion, cc-by-nc-nd)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Funders
- British Heart Foundation (CS/15/7/31679)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- ticagrelor, aspirin, dual antiplatelet therapy, ticagrelor monotherapy, diabetes mellitus, percutaneous coronary intervention, bleeding risk, ischemic events, P2Y12 inhibitors, coronary artery disease, multivessel coronary artery disease, myocardial infarction, stroke, all-cause mortality, high-risk patients
- MeSH terms
- Ticagrelor, Aspirin, Diabetes Mellitus, Double-Blind Method, Drug Therapy, Combination, Hemorrhage, Humans, Platelet Aggregation Inhibitors, Postoperative Complications, Prospective Studies, Risk Factors, Purinergic P2Y Receptor Antagonists, Percutaneous Coronary Intervention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
