0 175

Cited 0 times in

Sex Differences in Outcomes of Ticagrelor Therapy With or Without Aspirin After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome: A Post Hoc Secondary Analysis of the TICO Randomized Clinical Trial

Authors
 Bom Lee  ;  Seung-Jun Lee  ;  Byeong-Keuk Kim  ;  Yong-Joon Lee  ;  Sung-Jin Hong  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Meyong-Ki Hong  ;  Yangsoo Jang 
Citation
 ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, Vol.43(6) : e218-e226, 2023-06 
Journal Title
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
ISSN
 1079-5642 
Issue Date
2023-06
MeSH
Acute Coronary Syndrome* / drug therapy ; Aspirin / adverse effects ; Drug-Eluting Stents* / adverse effects ; Female ; Hemorrhage / epidemiology ; Humans ; Male ; Percutaneous Coronary Intervention* / adverse effects ; Platelet Aggregation Inhibitors / adverse effects ; Sex Characteristics ; Ticagrelor / adverse effects
Keywords
drug- ; eluting stents ; incidence ; sex ; thrombosis ; ticagrelor
Abstract
Background: We sought to explore the sex differences in clinical outcomes among patients with acute coronary syndrome treated with ticagrelor monotherapy after ticagrelor-based 3-month versus 12-month dual-antiplatelet therapy.

Methods: This was a post hoc analysis of the TICO trial (Ticagrelor Monotherapy After 3 Months in the Patients Treated With New Generation Sirolimus-Eluting Stent for Acute Coronary Syndrome; n=3056)—a randomized controlled trial for patients with acute coronary syndrome treated with drug-eluting stent. The primary outcome was a net adverse clinical event (composite of major bleeding, death, myocardial infarction, stent thrombosis, stroke, or target-vessel revascularization) 1 year after drug-eluting stent implantation. Secondary outcomes included major bleeding and major adverse cardiac and cerebrovascular events.

Results: There were 27.3% (n=628) women in the TICO trial; they were older with lower body mass index and higher prevalence of hypertension, diabetes, or chronic kidney disease than men. Compared with men, women had higher risk of net adverse clinical events (hazard ratio [HR], 1.89 [95% CI, 1.34–2.67]), major adverse cardiac and cerebrovascular events (HR, 1.69 [95% CI, 1.07–2.68]), and major bleeding (HR, 2.04 [95% CI, 1.25–3.35]). Among the groups stratified by sex and dual-antiplatelet therapy strategy, the incidences of primary and secondary outcomes were significantly different and the highest in women with ticagrelor-based 12-month dual-antiplatelet therapy (P<0.001). There was no significant heterogeneity in the impact of treatment strategy on the risks of primary and secondary outcomes between both sexes. Ticagrelor monotherapy was associated with a lower risk of the primary outcome in women (HR, 0.47 [95% CI, 0.26–0.85]; P=0.02) and comparable in men (HR, 0.77 [95% CI, 0.52–1.14]; P=0.19) without significant interaction (P for interaction, 0.18).

Conclusions: After percutaneous coronary intervention for acute coronary syndrome, women demonstrated worse clinical outcomes than men. Ticagrelor monotherapy after 5-month dual-antiplatelet therapy was associated with significantly lower risk of net adverse clinical events in women without sex interaction.
Full Text
https://www.ahajournals.org/doi/10.1161/ATVBAHA.122.318725
DOI
10.1161/atvbaha.122.318725
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Lee, Seung-Jun(이승준) ORCID logo https://orcid.org/0000-0002-9201-4818
Lee, Yong Joon(이용준)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195453
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links