{"id":"74f7584a382c","type":"article","url":"https://hartvaat.nl/2019/10/22/ticagrelor-monotherapie-bij-multivaten-pci-werkzaamheid-en-veiligheid/","title":"Ticagrelor monotherapie bij multivaten-PCI: werkzaamheid en veiligheid","title_en":"Efficacy and Safety of Ticagrelor Monotherapy in Patients Undergoing Multivessel PCI.","category":"algemeen","category_label":"Algemeen","professions":["apotheker","cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2019.08.997","source_url":"https://doi.org/10.1016/j.jacc.2019.08.997","authors":["Kuniaki Takahashi","Patrick W Serruys","Ply Chichareon","Chun Chin Chang","Mariusz Tomaniak","Rodrigo Modolo","Norihiro Kogame","Michael Magro","Saqib Chowdhary","Ingo Eitel","Robert Zweiker","Paul Ong","Michael Mundt Ottesen","Jan G P Tijssen","Joanna J Wykrzykowska","Robbert J de Winter","Scot Garg","Hans-Peter Stoll","Christian Hamm","Philippe Gabriel Steg","Yoshinobu Onuma","Marco Valgimigli","Pascal Vranckx","Didier Carrie","Stephan Windecker"],"significance":6,"published":"2019-10-22","source_date":"2019-10-22","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/"],"congress":"","summary_en":"This study evaluated ticagrelor monotherapy after short DAPT in patients undergoing multivessel PCI, extending the de-escalation evidence to the complex multi-stent population.","created":"2026-07-03T10:28:13Z","updated":"2026-07-03T13:27:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar werkzaamheid en veiligheid van ticagrelor monotherapie bij patiënten die multivaten-PCI ondergaan.","abstract_original":"BACKGROUND: Data on optimal antiplatelet treatment regimens in patients who undergo multivessel percutaneous coronary intervention (PCI) are sparse. OBJECTIVES: This post hoc study investigated the impact of an experimental strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) versus a reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) according to multivessel PCI. METHODS: The GLOBAL LEADERS trial is a prospective, multicenter, open-label, randomized controlled trial, allocating all-comer patients in a 1:1 ratio to either the experimental strategy or the reference regimen. The primary endpoint was the composite of all-cause death or new Q-wave myocardial infarction at 2 years. The secondary safety endpoint was Bleeding Academic Research Consortium type 3 or 5 bleeding. RESULTS: Among the overall study population (n=15,845), 3,576 patients (22.4%) having multivessel PCI experienced a significantly higher risk of ischemic and bleeding events at 2 years, compared to those having single-vessel PCI. There was an interaction between the experimental strategy and multivessel PCI on the primary endpoint (hazard ratio: 0.62; 95% confidence interval: 0.44 to 0.88; pinteraction = 0.031). This difference was largely driven by a lower risk of all-cause mortality. In contrast, the risk of Bleeding Academic Research Consortium type 3 or 5 bleeding was statistically similar between the 2 regimens (hazard ratio: 0.92; 95% confidence interval: 0.61 to 1.39; pinteraction = 0.754). CONCLUSIONS: Long-term ticagrelor monotherapy following 1-month DAPT can favorably balance ischemic and bleeding risks in patients with multivessel PCI. These findings should be interpreted as hypothesis-generating and need to be replicated in future dedicated randomized trials. (GLOBAL LEADERS: A Clinical Study Comparing Two Forms of Anti-platelet Therapy After Stent Implantation; NCT01813435)."}