Bibliographic Details
| Title: |
Sex-based outcomes on unguided de-escalation from ticagrelor to clopidogrel in stabilized patients with acute myocardial infarction undergoing percutaneous coronary intervention: a post-hoc analysis of the TALOS-AMI |
| Authors: |
Eun-Seok Shin, Eun Jung Jun, Bitna Kim, Chan Joon Kim, Mahn-Won Park, Eun-Ho Choo, Byung-Hee Hwang, Kwan Yong Lee, Gyu-Chul Oh, Min Chul Kim, Hyeon Woo Yim, Youngkeun Ahn, Kiyuk Chang |
| Source: |
Frontiers in Cardiovascular Medicine, Vol 11 (2024) |
| Publisher Information: |
Frontiers Media S.A., 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Diseases of the circulatory (Cardiovascular) system |
| Subject Terms: |
sex, acute myocardial infarction, clopidogrel, ticagrelor, percutaneous coronary intervention, drug-eluting stent, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| More Details: |
BackgroundThe TALOS-AMI study highlighted the effectiveness of a de-escalation strategy shifting from ticagrelor to clopidogrel 1 month after percutaneous coronary intervention (PCI), resulting in significant reduction in clinical events, primarily attributed to a substantial decrease in bleeding events. Nevertheless, the impact of this strategy on outcomes based on sex remains unclear.MethodsThis was a post-hoc analysis of the TALOS-AMI study. At 1 month after PCI, patients who remained adherent to aspirin and ticagrelor without experiencing major adverse events were randomized into either the de-escalation group (clopidogrel plus aspirin) or the active control group (ticagrelor plus aspirin) for an additional 12 months. The primary endpoint encompassed a composite of cardiovascular death, myocardial infarction, stroke, and Bleeding Academic Research Consortium bleeding type 2 or greater at 12 months after randomization.ResultsAmong the 2,697 patients included in this study, 454 (16.8%) were women. Women, characterized by older age and a higher prevalence of hypertension, diabetes, impaired renal function, and non-ST-segment myocardial infarction, exhibited a lower primary endpoint at 12 months compared to men [adjusted hazards ratio (HR), 0.60; 95% confidence interval (CI), 0.37–0.95; P = 0.03]. Compare to the active control group, the de-escalation group demonstrated a reduced risk of the primary endpoint in both women (adjusted HR, 0.38; 95% CI, 0.15–0.95; P = 0.039) and men (adjusted HR, 0.56; 95% CI, 0.40–0.79; P = 0.001) (interaction P = 0.46).ConclusionsIn stabilized patients post-PCI with drug-eluting stents for acute myocardial infarction, the primary endpoint was lower among women compared to men. In this cohort, the benefits of an unguided de-escalation strategy from ticagrelor to clopidogrel were comparable in women and men. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2297-055X |
| Relation: |
https://www.frontiersin.org/articles/10.3389/fcvm.2024.1358657/full; https://doaj.org/toc/2297-055X |
| DOI: |
10.3389/fcvm.2024.1358657 |
| Access URL: |
https://doaj.org/article/6a42306f5f184c269c4829c13c116a54 |
| Accession Number: |
edsdoj.6a42306f5f184c269c4829c13c116a54 |
| Database: |
Directory of Open Access Journals |
