TICO DEFINITION TRIAL

TICO DEFINITION TRIAL

Briefly, the TICO trial was an investigator‐initiated, multicenter, randomized, unblinded trial conducted at 38 centers in Korea. On the basis of the above, we sought to evaluate the clinical and procedural factors related to clinically relevant bleeding in patients with ACS treated with ticagrelor after coronary stent implantation.įrom the TICO (Ticagrelor Monotherapy After 3 Months in Patients Treated With a New Generation Sirolimus‐Eluting Stent for Acute Coronary Syndrome) trial, 5 a total of 2660 patients with ACS treated with ticagrelor were included for the present study. 4 Given the beneficial effects of this potent P2Y12 inhibitor on ischemia, it is clinically essential to assess the risk of bleeding with ticagrelor therapy. Results from a recent network meta‐analysis confirmed increased bleeding with ticagrelor treatment compared with clopidogrel. In the PLATO (Platelet Inhibition and Patient Outcomes) trial, 3 ticagrelor (compared with clopidogrel) resulted in fewer ischemic complications but led to more frequent major bleeding events not related to coronary artery bypass grafting. 1, 2 Although ticagrelor reduces ischemic events in these patients, bleeding is a major treatment‐related concern. It is reasonable to use ticagrelor in preference to clopidogrel for maintenance P2Y12 inhibitor therapy in patients with acute coronary syndrome (ACS) treated with dual antiplatelet therapy (DAPT) after coronary stent implantation. These bleeding factors may be considered for adopting ticagrelor as P2Y12 inhibitor therapy among patients with acute coronary syndrome undergoing drug‐eluting stent implantation. The lower risk of a net adverse clinical event (a composite of TIMI major bleeding and major adverse cardiac and cerebrovascular events) in patients treated with 3‐month aspirin therapy reported from the TICO trial remained valid in patients with any of these risk factors (hazard ratio, 0.59 95% CI, 0.39–0.90 P interaction=0.74). In contrast, 3‐month aspirin therapy with continued ticagrelor (versus 12‐month aspirin and ticagrelor) was associated with a decreased risk of major bleeding. On the basis of multivariable and receiver operating characteristic curve analyses, weight ≤65 kg, hemoglobin ≤12 g/dL, and estimated glomerular filtration rate <60 mL/min per 1.73 m 2 were associated with an increased risk of major bleeding. Patients with major bleeding, defined by TIMI (Thrombolysis in Myocardial Infarction) major or Bleeding Academic Research Consortium type 3 or 5, were compared with those without major bleeding. Stroke: Vascular and Interventional Neurologyįrom the TICO (Ticagrelor Monotherapy After 3 Months in Patients Treated With New Generation Sirolimus‐Eluting Stent for Acute Coronary Syndrome) randomized trial, a total of 2660 patients were included for the present study.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).

Tico definition