In:
Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 10 ( 2023-3-30)
Abstract:
Although ticagrelor monotherapy after 3-month dual antiplatelet therapy (DAPT) results in a significantly greater net clinical benefit over that with ticagrelor-based 12-month DAPT in patients with acute coronary syndrome (ACS), it remains uncertain whether this effect is dependent on body mass index (BMI). We aimed to evaluate the BMI-dependent effect of these treatment strategies on clinical outcomes. Methods This was a pre-specified subgroup analysis from the TICO trial (Ticagrelor Monotherapy After 3 Months in Patients Treated With New Generation Sirolimus-eluting Stent for Acute Coronary Syndrome), evaluating the interaction between BMI and treatment strategies for the primary outcome [composite of major bleeding and adverse cardiac and cerebrovascular events (MACCE): death, myocardial infarction, stent thrombosis, stroke, or target-vessel revascularization] . The secondary outcomes were major bleeding and MACCE. Results Based on a pre-specified BMI threshold of 25 kg/m 2 , 3,056 patients were stratified. Patients with BMI & lt;25 kg/m 2 had a higher risk of primary and secondary outcomes than those with BMI ≥25 kg/m 2 . Regardless of the BMI subgroup, the effects of ticagrelor monotherapy after 3-month DAPT on the primary outcome ( p int = 0.61), major bleeding ( p int = 0.76), and MACCE ( p int = 0.80) were consistent without significant interaction compared with ticagrelor-based 12-month DAPT. The treatment effects according to the BMI quartiles and age, sex, and diabetic status were also consistent without significant interaction. Conclusion The BMI-dependent impact of ticagrelor monotherapy after 3-month DAPT compared with 12-month DAPT on clinical outcomes was not heterogeneous in patients with ACS. Clinical Trial Registration [ www.ClinicalTrials.gov ], identifier [NCT02494895] .
Type of Medium:
Online Resource
ISSN:
2297-055X
DOI:
10.3389/fcvm.2023.1128834
DOI:
10.3389/fcvm.2023.1128834.s001
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2023
detail.hit.zdb_id:
2781496-8
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