Cited by 1,999Antiplatelet Therapy and Cardiovascular DiseasesAcute Myocardial Infarction ResearchCoronary Interventions and Diagnostics

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Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction

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Bonaca, Marc P., Bhatt, Deepak L., Cohen, Marc, Steg, Philippe Gabriel, Storey, Robert F., Jensen, Eva C., Magnani, Giulia, Bansilal, Sameer, Fish, M. Polly, Im, Kyungah, Bengtsson, Olof, Ophuis, Ton Oude, Budaj, Andrzej, Theroux, Pierre, Ruda, Mikhail, Hamm, Christian, Goto, Shinya, Spinar, Jindrich, Nicolau, José Carlos, Kiss, Robert G., Murphy, Sabina A., Wiviott, Stephen D., Held, Peter, Braunwald, Eugene, Sabatine, Marc S.·2015·New England Journal of Medicine

DOI 10.1056/nejmoa1500857

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Abstract

BACKGROUND: The potential benefit of dual antiplatelet therapy beyond 1 year after a myocardial infarction has not been established. We investigated the efficacy and safety of ticagrelor, a P2Y12 receptor antagonist with established efficacy after an acute coronary syndrome, in this context. METHODS: We randomly assigned, in a double-blind 1:1:1 fashion, 21,162 patients who had had a myocardial infarction 1 to 3 years earlier to ticagrelor at a dose of 90 mg twice daily, ticagrelor at a dose of 60 mg twice daily, or placebo. All the patients were to receive low-dose aspirin and were followed for a median of 33 months. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The primary safety end point was Thrombolysis in Myocardial Infarction (TIMI) major bleeding. RESULTS: The two ticagrelor doses each reduced, as compared with placebo, the rate of the primary efficacy end point, with Kaplan-Meier rates at 3 years of 7.85% in the group that received 90 mg of ticagrelor twice daily, 7.77% in the group that received 60 mg of ticagrelor twice daily, and 9.04% in the placebo group (hazard ratio for 90 mg of ticagrelor vs. placebo, 0.85; 95% confidence interval [CI], 0.75 to 0.96; P=0.008; hazard ratio for 60 mg of ticagrelor vs. placebo, 0.84; 95% CI, 0.74 to 0.95; P=0.004). Rates of TIMI major bleeding were higher with ticagrelor (2.60% with 90 mg and 2.30% with 60 mg) than with placebo (1.06%) (P<0.001 for each dose vs. placebo); the rates of intracranial hemorrhage or fatal bleeding in the three groups were 0.63%, 0.71%, and 0.60%, respectively. CONCLUSIONS: In patients with a myocardial infarction more than 1 year previously, treatment with ticagrelor significantly reduced the risk of cardiovascular death, myocardial infarction, or stroke and increased the risk of major bleeding. (Funded by AstraZeneca; PEGASUS-TIMI 54 ClinicalTrials.gov number, NCT01225562.).

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ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary
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ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation
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Prasugrel versus clopidogrel in patients with acute coronary syndromes
Wiviott, S. D., Braunwald, E., McCabe, C. H., Montalescot, G., Ruzyllo, W., Gottlieb, S., Neumann, F.-J., Ardissino, D., De Servi, S., Murphy, S. A., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa0706482 · Cited by 6,790
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“In the PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin–Thrombolysis in Myocardial Infarction 54) trial, long-term DAPT with ticagrelor in addition to aspirin provided a 16% reduction in adverse ischemic events in p…”
BackgroundMethod
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“AUC0-t, ng·h/mLa 5923 (25) 2158 (22) 7110 (60) 2420 (19)”
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“The TIMI definition combines clinical and laboratory data to identify major bleeding events [18], including fatal or intracranial bleeding or a drop in hemoglobin levels of more than 5 g/dL with associated clinical signs of hemorrhage.”
Method
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“ment,[48] more patients may need major surgery – cardiac”
Background
The optimal duration of dual antiplatelet therapy after coronary stent implantation: to go too far is as bad as to fall short
Costa, F., & Valgimigli, M. (2018) · Cardiovascular Diagnosis and Therapy · doi:10.21037/cdt.2018.10.01 · Cited by 20
“At a more thorough evaluation of the single fatal events, most were related to cancer (39), and despite this signal was observed also in other studies (37), the authors attributed this finding to chance.”
Result
Prediction of Ischemic and Bleeding Events Using the Dual Antiplatelet Therapy Score in an Unrestricted Percutaneous Coronary Intervention Population
Brener, S. J., Kirtane, A. J., Rinaldi, M. J., Stuckey, T., Witzenbichler, B., Weisz, G., Neumann, F., Metzger, D. C., Henry, T. D., Cox, D. A., et al. (2018) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.118.006853 · Cited by 20
Network Meta-Analysis of Ticagrelor for Stroke Prevention in Patients at High Risk for Cardiovascular or Cerebrovascular Events
Bálint, A., Tornyos, D., Abdallaoui, O. E. A. E., Kupó, P., & Komócsi, A. (2021) · Stroke · doi:10.1161/strokeaha.120.032670 · Cited by 21
Eurasian Guidelines for the diagnostics and management of stable coronary artery disease (2020-2021)
IuA, K., Барбараш, О. Л., Boshchenko, A. A., Кашталап, В. В., Kukharchuk, V. V., Миронов, В. М., Панченко, Е. П., Ruda, M. M., Samko, A. N., Соболева, Г. Н., et al. (2021) · Eurasian heart journal · doi:10.38109/2225-1685-2021-3-54-93 · Cited by 22
Self-citation
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“CCS) and patient-specific ischemic (clinical and procedure-related factors) and bleeding risks [4,23,46,47].”
Background
Antiplatelet Strategies Following PCI: A Review of Trials Informing Current and Future Therapies
Thomas, A. W., Gitto, M., Shah, S., Saito, Y., Tı̂rziu, D., Chieffo, A., Stefanini, G. G., & Lansky, A. J. (2023) · Journal of the Society for Cardiovascular Angiography & Interventions · doi:10.1016/j.jscai.2023.100607 · Cited by 21
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Self-citation
Individualizing Duration of Dual Antiplatelet Therapy After Acute Coronary Syndrome or Percutaneous Coronary Intervention
Bagai, A., Bhatt, D. L., Eikelboom, J. W., Mancini, G. B. J., Cohen, E. A., Vijayaraghavan, R., Cheema, A. N., Udell, J. A., Niznick, J., Tanguay, J., et al. (2016) · Circulation · doi:10.1161/circulationaha.115.021158 · Cited by 20
“A second trial, Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin–Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54), showed a reduction in ischemic events with ticagrelor in high-risk patients with a prior MI 1 to 3 years be…”
MethodSelf-citation
Duration of dual antiplatelet therapy in patients treated with percutaneous coronary intervention for coronary chronic total occlusion
Lee, S. H., Yang, J. H., Choi, S., Park, T. K., Jang, W. J., Song, Y. B., Hahn, J., Choi, J., & Gwon, H. (2017) · PLoS ONE · doi:10.1371/journal.pone.0176737 · Cited by 20
Optimal duration of dual antiplatelet therapy for coronary artery disease
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“The lowest number to treat and highest number to harm was observed with the dose of 60mg twice daily [35].”
Background
Ticagrelor for stroke prevention in patients with vascular risk factors: A systematic review and meta-analysis
Malhotra, K., Goyal, N., Kasunich, A. S., Sheth, S. A., Katsanos, A. H., Alexandrov, A. V., & Tsivgoulis, G. K. (2018) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2018.05.001 · Cited by 20
Laboratory monitoring of P2Y12 inhibitors: communication from the SSC of the ISTH
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Atherothrombotic risk stratification after acute myocardial infarction: The Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention in the light of the French Registry of Acute ST Elevation or non‐ST Elevation Myocardial Infarction registries
Puymirat, É., Bonaca, M. P., Fumery, M., Tea, V., Aïssaoui, N., Lemesles, G., Bonello, L., Ducrocq, G., Cayla, G., Ferrières, J., et al. (2018) · Clinical Cardiology · doi:10.1002/clc.23131 · Cited by 20
“Aspirin 3085 (24) 653 (12) 712 (23) 1720 (41) <0.”
Self-citation
Utility of the HAS-BLED score for risk stratification of patients with acute coronary syndrome
Castini, D., Persampieri, S., Sabatelli, L., Erba, M., Ferrante, G., Valli, F., Centola, M., & Carugo, S. (2019) · Heart and Vessels · doi:10.1007/s00380-019-01405-1 · Cited by 20
Extended Duration of Dual‐Antiplatelet Therapy After Percutaneous Coronary Intervention: How Long Is Too Long?
Howard, C. E., Nambi, V., Jneid, H. M., & Khalid, U. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.012639 · Cited by 20
“However, there was no statistically significant difference in severe GUSTO or fatal bleeding.(2,5) As noted above, 2 of these 4 trials showed an improved primary efficacy end point of >24 months DAPT compared with standard 12-month DAPT, whereas the other 2 showed no difference.”
BackgroundMethodResultInfluential
Impact of renal function on clinical outcomes after PCI in ACS and stable CAD patients treated with ticagrelor: a prespecified analysis of the GLOBAL LEADERS randomized clinical trial
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Self-citation
An Important Step for Thrombocardiology
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Bias and Loss to Follow‐Up in Cardiovascular Randomized Trials: A Systematic Review
Fong, L. C. W., Ford, T. J., da Costa, B. R., Jüni, P., & Berry, C. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.119.015361 · Cited by 19
Effects of Acute Coronary Syndrome and Stable Coronary Artery Disease on Bleeding and Ischemic Risk After Percutaneous Coronary Intervention
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Current management and prognosis of patients with recurrent myocardial infarction
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A Comprehensive Review of the Pleiotropic Effects of Ticagrelor
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“%) with a HR = 0.84, 95% CI = 0.72–0.98; p = 0.03 [76].”
Influential
A Contemporary Review of Antiplatelet Therapies in Current Clinical Practice
Arockiam, S., Staniforth, B., Kepreotis, S., Maznyczka, A., & Bulluck, H. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241311132 · Cited by 21
“Based on the promising results in a subgroup of patients in the CHARISMA trial [62], the role of prolonged DAPT with ticagrelor and aspirin for secondary prevention in highrisk stable patients (age > 65 years, chronic kidney disease, second presentation of MI, multi vessel coronary artery disease and diabetes mellitus…”
Result
Review of the Ticagrelor Trials Evidence Base
Herron, G. C., & Bates, E. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.031606 · Cited by 21
Targeting purine metabolism-related enzymes for therapeutic intervention: A review from molecular mechanism to therapeutic breakthrough
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Antithrombotic Therapy for Secondary Prevention in Patients With Diabetes Mellitus and Coronary Artery Disease
Park, Y., Franchi, F., Rollini, F., & Angiolillo, D. J. (2016) · Circulation Journal · doi:10.1253/circj.cj-16-0208 · Cited by 19
Pharmacodynamics, pharmacokinetics, and safety of ticagrelor in Chinese patients with stable coronary artery disease
Li, H., Guo, J. S., Carlson, G. F., & Teng, R. (2016) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.12950 · Cited by 20
Fibrin clot strength measured by thrombelastography and outcomes after percutaneous coronary intervention
Kreutz, R. P., Schmeisser, G., Maatman, B. T., Schaffter, A., Sinha, A. K., von der Lohe, E., & Breall, J. A. (2016) · Thrombosis and Haemostasis · doi:10.1160/th16-10-0496 · Cited by 19
A randomized clinical trial comparing long-term clopidogrel vs aspirin monotherapy beyond dual antiplatelet therapy after drug-eluting coronary stent implantation: Design and rationale of the Harmonizing Optimal Strategy for Treatment of coronary artery stenosis-Extended Antiplatelet Monotherapy (HOST-EXAM) trial
Lee, H., Koo, B., Park, K. W., Shin, E., Lim, S. W., Rha, S., Bae, J., Jeon, D. W., Oh, S.-K., Hur, S., et al. (2016) · American Heart Journal · doi:10.1016/j.ahj.2016.12.001 · Cited by 19
Quantifying Ischemic Risk After Percutaneous Coronary Intervention Attributable to High Platelet Reactivity on Clopidogrel (From the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents Study)
Redfors, B., Ben‐Yehuda, O., Lin, S., Furer, A., Kirtane, A. J., Witzenbichler, B., Weisz, G., Stuckey, T., Maehara, A., Généreux, P., et al. (2017) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2017.06.019 · Cited by 19
The quest for safer antithrombotic treatment regimens in patients with coronary artery disease: new strategies and paradigm shifts
Moon, J. Y., Franchi, F., Rollini, F., & Angiolillo, D. J. (2017) · Expert Review of Hematology · doi:10.1080/17474086.2018.1400378 · Cited by 19
“(Long-term use of ticagrelor in patients with prior myocardial infarction) trial [41].”
Background
Impact of adenosine A2a receptor polymorphism rs5751876 on platelet reactivity in ticagrelor treated patients
Nardin, M., Verdoia, M., Pergolini, P., Rolla, R., Barbieri, L., Marino, P. N., Bellomo, G., Kedhi, E., Suryapranata, H., Carriero, A., et al. (2018) · Pharmacological Research · doi:10.1016/j.phrs.2017.12.035 · Cited by 19
Anticoagulation in Atherosclerotic Disease
Bode, C., Duerschmied, D., & Said, S. A. (2018) · Hämostaseologie · doi:10.1055/s-0038-1673412 · Cited by 19
EURASIAN ASSOCIATION OF CARDIOLOGY (EAC) GUIDELINES FOR THE PREVENTION AND TREATMENT OF CARDIOVASCULAR DISEASES IN PATIENTS WITH DIABETES AND PREDIABETES (2021)
Chazova, I. E., Shestakova, M. V., Zhernakova, Y. V., Blinova, N. V., Маркова, Т. Н., Mazurina, N. V., Владиславович, Е. М., Tereshchenko, S. N., Жиров, И. В., Komarov, A. L., et al. (2021) · Eurasian heart journal · doi:10.38109/2225-1685-2021-2-6-61 · Cited by 19
Comparison of Incidence and Prognostic Impact of Ischemic, Major Bleeding and Heart Failure Events in Patients With Chronic Coronary Syndrome: Insights From the CORONOR Registry
Lemesle, G., Lamblin, N., Schurtz, G., Labreuche, J., Duhamel, A., Verdier, B., Steg, P. G., & Bauters, C. (2024) · Circulation · doi:10.1161/circulationaha.123.067938 · Cited by 18
Self-citation
State of the art: Oral antiplatelet therapy
Gurbel, P. A., Myat, A., Kubica, J., & Tantry, U. S. (2016) · JRSM Cardiovascular Disease · doi:10.1177/2048004016652514 · Cited by 18
Impact of Advanced Age on the Incidence of Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes Mellitus and Stable Coronary Artery Disease in a Real-World Setting in Spain
González‐Juanatey, C., Anguita-Sánchez, M. P., Barrios, V., Nuñez-Gil, I. J., Gómez‐Doblas, J. J., García–Moll, X., Gormaz, C. L., Rollán-Gómez, M. J., Peral-Disdier, V., Martínez‐Dolz, L., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12165218 · Cited by 20
“THEMIS trial, ClinicalTrials.gov number NCT01991795; PEGASUS-TIMI 54 trial, ClinicalTrials.gov number NCT01225562.”
ResultInfluential
Impact of the 2021 European Society for Cardiology prevention guideline’s stepwise approach for cardiovascular risk factor treatment in patients with established atherosclerotic cardiovascular disease
Holtrop, J., Bhatt, D. L., Ray, K. K., Mach, F., Smulders, Y. M., Carballo, D., Steg, P. G., Visseren, F. L. J., & Dorresteijn, J. A. N. (2024) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwae038 · Cited by 19
Self-citation
Effect of Ticagrelor Versus Clopidogrel on Vascular Reactivity
Alemayehu, M., Kim, R. B., Lavi, R., Gong, I. Y., D’Alfonso, S., Mansell, S. E., Wall, S., & Lavi, S. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.02.048 · Cited by 18
“To date, 11 amyloidogenic proteins have been documented in the heart (1).”
Background
Platelet transfusion to reverse antiplatelet therapy before decompressive surgery in patients with intracranial haemorrhage
Baschin, M., Selleng, S., Zeden, J.-P., Westphal, A., Kohlmann, T., Schroeder, H. W. S., Greinacher, A., & Thiele, T. (2017) · Vox Sanguinis · doi:10.1111/vox.12542 · Cited by 17
Clinician's Guide to the Updated ABCs of Cardiovascular Disease Prevention: A Review Part 1
Arps, K. E., Pallazola, V. A., Cardoso, R. N., Meyer, J., Jones, R., Latina, J. M., Gluckman, T. J., Stone, N. J., Blumenthal, R. S., & McEvoy, J. W. (2019) · The American Journal of Medicine · doi:10.1016/j.amjmed.2019.01.016 · Cited by 18
Risk of Ischemic Stroke After Acute Myocardial Infarction in Patients Undergoing Coronary Artery Bypass Graft Surgery
Åström, A., Söderström, L., & Mooe, T. (2020) · Scientific Reports · doi:10.1038/s41598-020-60854-1 · Cited by 18
Prolonged antithrombotic therapy in patients after acute coronary syndrome: A critical appraisal of current European Society of Cardiology guidelines
Kubica, J., Adamski, P., Niezgoda, P., Alexopoulos, D. K., Badarienė, J., Budaj, A., Buszko, K., Dudek, D., Fabiszak, T., Gąsior, M., et al. (2020) · Cardiology Journal · doi:10.5603/cj.a2020.0132 · Cited by 20
Self-citation
Chronisches Koronarsyndrom
Jurisch, D., & Laufs, U. (2020) · Der Internist · doi:10.1007/s00108-020-00910-0 · Cited by 19
P2Y12 Antiplatelet Choice for Patients with Chronic Kidney Disease and Acute Coronary Syndrome: A Systematic Review and Meta-Analysis
Park, S., Choi, Y. J., Kang, J. E., Kim, M. G., Geum, M. J., Kim, S., & Rhie, S. J. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11030222 · Cited by 18
Potential Relation between Plasma BDNF Levels and Human Coronary Plaque Morphology
Amadio, P., Cosentino, N., Eligini, S., Barbieri, S., Tedesco, C. C., Sandrini, L., Zarà, M., Fabbiocchi, F., Niccoli, G., Magnani, G., et al. (2021) · Diagnostics · doi:10.3390/diagnostics11061010 · Cited by 18
Self-citation
Risk-Benefit of 1-Year DAPT After DES Implantation in Patients Stratified by Bleeding and Ischemic Risk
Palmerini, T., Bruno, A. G., Redfors, B., Valgimigli, M., Taglieri, N., Feres, F., Abizaid, A., da Costa, R. A., Gilard, M., Morice, M., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.08.070 · Cited by 18
Ticagrelor or prasugrel versus clopidogrel in patients undergoing percutaneous coronary intervention for chronic coronary syndromes
Koshy, A. N., Giustino, G., Sartori, S., Hooda, A., Feng, Y., Snyder, C., Dasgupta, S., Kumar, K. R., Krishnamoorthy-Melarcode, P., Sweeny, J. M., et al. (2023) · EuroIntervention · doi:10.4244/eij-d-22-00654 · Cited by 21
Identification of a New Morpholine Scaffold as a P2Y12 Receptor Antagonist
Ahn, Y. H., Lee, J.-Y., Park, H., Kim, T. I., Park, M., Choi, G., & Kim, S. (2016) · Molecules · doi:10.3390/molecules21091114 · Cited by 18
Six Versus Twelve Months Clopidogrel Therapy After Drug-Eluting Stenting in Patients With Acute Coronary Syndrome: An ISAR-SAFE Study Subgroup Analysis
Lohaus, R., Michel, J., Mayer, K., Lahmann, A. L., Byrne, R. A., Wolk, A., ten Berg, J. M., Neumann, F., Han, Y., Adriaenssens, T., et al. (2016) · Scientific Reports · doi:10.1038/srep33054 · Cited by 18
Bleeding risk following percutaneous coronary intervention in patients with diabetes prescribed dual anti-platelet therapy
Grodzinsky, A., Arnold, S. V., Wang, T. Y., Sharma, P. K., GOSCH, K. L., Jones, P. G., Bhatt, D. L., Steg, P. G., McGuire, D. K., Cohen, D. J., et al. (2016) · American Heart Journal · doi:10.1016/j.ahj.2016.09.010 · Cited by 18
Self-citation
Safety and efficacy of vorapaxar in secondary prevention of atherosclerotic disease: A meta-analysis of randomized control trials
Sharma, A., Helft, G., Garg, A., Agrawal, S., Chatterjee, S., Lavie, C. J., Goel, S., Mukherjee, D., & Marmur, J. D. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.10.088 · Cited by 18
Dual vs single antiplatelet therapy in patients with lower extremity peripheral artery disease – A meta-analysis
Navarese, E. P., Wernly, B., Lichtenauer, M., Petrescu, A. M., Kołodziejczak, M. M., Lauten, A., Frediani, L., Veulemanns, V., Wańha, W., Wojakowski, W., et al. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.07.009 · Cited by 18
De-escalation of anti-platelet therapy in patients with acute coronary syndromes undergoing percutaneous coronary intervention
Han, Y. (2019) · Chinese Medical Journal · doi:10.1097/cm9.0000000000000047 · Cited by 18
Epidemiology, treatment patterns and outcomes in patients with coronary or lower extremity artery disease in France
Guedeney, P., Aboyans, V., Dalon, F., Oksen, D., Belhassen, M., Nolin, M., Brière, J., Ganse, E. H. V., & Montalescot, G. (2019) · Archives of cardiovascular diseases · doi:10.1016/j.acvd.2019.05.009 · Cited by 18
External applicability of the COMPASS trial: the Western Denmark Heart Registry
Würtz, M., Olesen, K. K. W., Thim, T., Kristensen, S. D., Eikelboom, J. W., & Mæng, M. (2019) · European Heart Journal - Cardiovascular Pharmacotherapy · doi:10.1093/ehjcvp/pvz013 · Cited by 17
Effects of Monotherapy with Clopidogrel vs. Aspirin on Vascular Function and Hemostatic Measurements in Patients with Coronary Artery Disease: The Prospective, Crossover I-LOVE-MONO Trial
Park, H. W., Kang, M.-G., Ahn, J., BAE, J., Tantry, U. S., Gurbel, P. A., & Jeong, Y. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10122720 · Cited by 17
Towards personalized antithrombotic management with drugs and devices across the cardiovascular spectrum
Lüscher, T. F., Davies, A., Beer, J. H., Valgimigli, M., Nienaber, C. A., Camm, A. J., Baumgärtner, I., Diener, H., & Konstantinides, S. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab642 · Cited by 18
Antithrombotic therapy in patients with established atherosclerotic coronary disease
Landi, A., & Valgimigli, M. (2023) · Heart · doi:10.1136/heartjnl-2022-321603 · Cited by 17
A Review of Current Diagnosis, Investigation, and Management of Acute Coronary Syndromes in Elderly Patients
McCune, C., McKavanagh, P., & Menown, I. B. A. (2015) · Cardiology and Therapy · doi:10.1007/s40119-015-0047-x · Cited by 17
“A reduced dose of 60 mg twice daily as an alternative to 90 mg twice daily may be safer in the elderly as suggested by the PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54) t…”
Method
Duration of Dual Antiplatelet Therapy in Patients with an Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
Bavishi, C., Trivedi, V., Singh, M., Katz, E., Messerli, F. H., & Bangalore, S. (2017) · The American Journal of Medicine · doi:10.1016/j.amjmed.2017.05.029 · Cited by 17
Association of Diabetic Status and Glycemic Control With Ischemic and Bleeding Outcomes in Patients With Stable Coronary Artery Disease: The 5‐Year CORONOR Registry
Lemesle, G., Meurice, T., Tricot, O., Lamblin, N., & Bauters, C. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.117.008354 · Cited by 19
Oral Antiplatelet Therapy for Secondary Prevention of Acute Coronary Syndrome
Berger, J. S. (2018) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-018-0291-2 · Cited by 17
Review of the 2017 European Society of Cardiology's Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with ST-Segment Elevation and Focused Update on Dual Antiplatelet Therapy in Coronary Artery Disease Developed in Collaboration with the European Association for Cardio-Thoracic Surgery
Nuñez-Gil, I. J., Říha, H., & Ramakrishna, H. (2018) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2018.09.032 · Cited by 17
Increased platelet reactivity in dyslipidemic patients with coronary artery disease on dual anti-platelet therapy
Jäger, B., Piacková, E., Haller, P. M., Andric, T., Kahl, B. S., Christ, G., Geppert, A., Wojta, J., & Huber, K. (2019) · Archives of Medical Science · doi:10.5114/aoms.2018.81035 · Cited by 17
“However, the optimal duration of DAPT is an ongoing matter of debate [4] and distinct patients with high ischemic and low bleeding risk might benefit from extended DAPT [5].”
BackgroundResult
Ticagrelor induces paraoxonase-1 (PON1) and better protects hypercholesterolemic mice against atherosclerosis compared to clopidogrel
Halim, H., Pinkaew, D., Chunhacha, P., Sinthujaroen, P., Thiagarajan, P., & Fujise, K. (2019) · PLoS ONE · doi:10.1371/journal.pone.0218934 · Cited by 17
Evaluation of the Efficacy of Computed Tomographic Coronary Angiography in Assessing Coronary Artery Morphology and Physiology: Rationale and Study Design
Ramasamy, A., Safi, H., Moon, J., Andiapen, M., Rathod, K. S., Maurovich‐Horvat, P., Bajaj, R., Serruys, P. W. J. C., Mathur, A., Baumbach, A., et al. (2020) · Cardiology · doi:10.1159/000506537 · Cited by 17
The Combination of Oral Anticoagulant and Antiplatelet Therapies: Stay One Step Ahead
Lucà, F., Giubilato, S., Fusco, S. A. D., Leone, A., Poli, S., Rao, C. M., Iorio, A., Gelsomino, S., Gabrielli, D., Colivicchi, F., et al. (2020) · Journal of Cardiovascular Pharmacology and Therapeutics · doi:10.1177/1074248420923528 · Cited by 18
“However, ischemic protection was achieved at the expense of an increased rate of Thrombolysis in Myocardial Infarction (TIMI) major bleeding.(12) Previously, the DAPT trial investigated the benefits and risks of a prolonged DAPT strategy over >12 months versus aspirin alone in patients with or without MI.”
BackgroundMethod

Authors: Bonaca, M. P., Bhatt, D. L., Cohen, M., Steg, P. G., Storey, R. F., Jensen, E. C., Magnani, G., Bansilal, S., Fish, M. P., Im, K., Bengtsson, O., Ophuis, T. O., Budaj, A., Theroux, P., Ruda, M., Hamm, C., Goto, S., Spinar, J., Nicolau, J. C., Kiss, R. G., Murphy, S. A., Wiviott, S. D., Held, P., Braunwald, E., & Sabatine, M. S.
Affiliations: Newark Beth Israel Medical Center (US)
Brigham and Women's Hospital (US)
University of Sheffield (GB)
AstraZeneca (Sweden) (SE)
Icahn School of Medicine at Mount Sinai (US)
Canisius-Wilhelmina Ziekenhuis (NL)
Grochowski Hospital (PL)
National Medical Research Center of Cardiology (RU)
Justus-Liebig-Universität Gießen (DE)
Tokai University (JP)
Universidade de São Paulo (BR)
ORCID: Bonaca, Marc P.
Bhatt, Deepak L.
Cohen, Marc
Storey, Robert F.
Magnani, Giulia
Im, Kyungah
Bengtsson, Olof
Budaj, Andrzej
Hamm, Christian
Goto, Shinya
Nicolau, José Carlos
Murphy, Sabina A.
Wiviott, Stephen D.
Sabatine, Marc S.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2015-05-07
Volume: 372
Issue: 19
Pages: 1791-1800
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa1500857
OpenAlex: W2141358924
Cited by: 1,999
References: 32
Citations by year: 2026: 86 · 2025: 99 · 2024: 102 · 2023: 130 · 2022: 163 · 2021: 189 · 2020: 232 · 2019: 205 · 2018: 220 · 2017: 222 · 2016: 236 · 2015: 108
FWCI: 188.81
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
SZTE Publicatio Repozitórium (University of Szeged) (acceptedVersion, other-oa)
Open Repository and Bibliography (University of Liège) (submittedVersion, other-oa)
HAL (submittedVersion)
University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion, other-oa)
Digital Access to Libraries (submittedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Use Siena air (University of Siena) (submittedVersion)
Funders: Japan Society for the Promotion of Science (24390202)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
Keywords: ticagrelor, P2Y12 inhibitors, old myocardial infarction, dual antiplatelet therapy, long-term antiplatelet therapy, cardiovascular mortality, myocardial infarction, stroke, intracranial hemorrhage, aspirin, dose comparison, secondary prevention, bleeding risk, cardiovascular risk reduction
MeSH terms: Ticagrelor, Adenosine, Aged, Aspirin, Cardiovascular Diseases, Double-Blind Method, Drug Administration Schedule, Drug Therapy, Combination, Female, Hemorrhage, Humans, Male, Middle Aged, Myocardial Infarction, Platelet Aggregation Inhibitors, Risk, Intracranial Hemorrhages, Kaplan-Meier Estimate, Secondary Prevention, Purinergic P2Y Receptor Antagonists

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Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction

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