TY - JOUR JO - EuroIntervention TI - Impact of Ticagrelor Monotherapy on Two-Year Clinical Outcomes in Patients with Long Stenting: A Post Hoc Analysis of the Global Leaders Trial AB - [<span class="abstracts-titres">Aims:</span>]&nbsp;To evaluate the impact of a novel antiplatelet regimen in patients with increasing total stent length (TSL).&nbsp;[<br /><br /><span class="abstracts-titres">Methods and results:</span>]&nbsp;This is a post-hoc analysis of the Global Leaders trial, a prospective, multi-centre, open-label, randomised trial, investigating the impact of the experimental strategy (one-month dual antiplatelet regimen [DAPT] followed by 23-month ticagrelor monotherapy) versus the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) in patients with Biolimus A9-eluting stent (BES). The primary endpoint was the composite of the all-cause death and new Q-wave myocardial infarction (MI), and the secondary endpoint was Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding at two years. To investigate the association between total stent length and outcomes, groups were compared in quartiles according to TSL, and the fourth quartile group was at significantly higher ischemic risk at two years. In that stratum (TSL&ge; 46mm), the experimental strategy significantly reduced the risk of the primary endpoint (hazard ratio [HR]:0.67; 95% confidence interval [CI]:0.49-0.90; Pinteraction=0.043), while demonstrating a similar risk of BARC type 3 or 5 bleeding (HR:0.99; 95% CI:0.66-1.49; Pinteraction =0.975). [<br /><br /><span class="abstracts-titres">Conclusions:</span>]&nbsp;Ticagrelor monotherapy potentially could balance ischemic and bleeding risks, thereby achieving a net clinical benefit in patients with TSL&ge; 46 mm with BES. AU - Takahashi Kuniaki AU - Chichareon Ply AU - Modolo Rodrigo AU - Kogame Norihiro AU - Chang Chin Chun AU - Tomaniak Mariusz AU - Moschovitis Aris AU - Curzen Nick AU - Haude Michael AU - Jung Werner AU - Holmvang Lene AU - Garg Scot AU - Tijssen G.P. Jan AU - Wykrzykowska Joanna J. AU - de Winter J. Robbert AU - Hamm W. Christian AU - Steg P. Gabriel AU - Stoll Hans-Peter AU - Onuma Yoshinobu AU - Valgimigli Marco AU - Vranckx Pascal AU - Windecker Stephan AU - Serruys Patrick W. VL - IS - Y1 - 10/09/2019 Y1 - 2019 DOI - 10.4244/EIJ-D-19-00498 SP - KW - acs / nste-acs KW - stable angina KW - adjunctive pharmacotherapy KW - drug-eluting stent PB - Europa Digital & Publishing UR - https://eurointervention.pcronline.com/article/impact-of-ticagrelor-monotherapy-on-two-year-clinical-outcomes-in-patients-with-long-stenting-a-post-hoc-analysis-of-the-global-leaders-trial SN - 1774-024X ER -