Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Ticagrelor monotherapy tops DAPT for high-risk PCI patients

Key clinical point: After 3 months of DAPT, ticagrelor alone may be enough for high-risk patients after stenting.

Major finding: One year after randomization, 4% in the ticagrelor monotherapy group versus 7.1% in the ticagrelor plus aspirin arm reached the primary end point, actionable (type 2), severe (type 3), or fatal (type 5) bleeding on the Bleeding Academic Research Consortium scale (HR, 0.56; 95% CI, 0.45 - 0.68; P less than .001). There was no increase in ischemic events.

Study details: TWILIGHT, a randomized trial with more than 7,000 subjects.

Disclosures: The work was funded by ticagrelor’s maker, AstraZeneca. The lead investigator reported consulting and other relationships with Abbott, Janssen, and other companies.


Mehran R et al. N Engl J Med. 2019 Sep 26. doi: 10.1056/NEJMoa1908419.