TWILIGHT: A Groundbreaking Study
According to the latest issue of The New England Journal of Medicine, New results from the study, "Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention" (TWILIGHT), suggest that doctors treat high-risk cardiac patients following percutaneous coronary intervention (PCI) by withdrawing aspirin and using ticagrelor alone.

'This pivotal, first-ever study to withdraw aspirin in complex patients with coronary stents underlines the importance of bleeding avoidance strategies for targeted care. We showed that withdrawal of aspirin after three months in patients already on a potent antiplatelet regimen (ticagrelor) reduced bleeding significantly without the harm of increasing death or heart attacks,' said TWILIGHT's Global Principal Investigator, Roxana Mehran, MD, Director of the Center for Interventional Cardiovascular Research and Clinical Trials at Mount Sinai Heart and Professor of Cardiology, and Population Health Science and Policy, at Icahn School of Medicine at Mount Sinai.

TWILIGHT examined the impact of ticagrelor alone versus ticagrelor plus aspirin on clinically relevant bleeding among patients at high ischemic or bleeding risk undergoing PCI. Investigators tracked the occurrence of any clinically relevant bleeding, or adverse events such as death, heart attack, and stroke.

For patients who took ticagrelor and no aspirin (placebo), bleeding was reduced by 44 percent, compared to patients on ticagrelor combined with aspirin. 'The TWILIGHT trial is a landmark trial which will change our PCI practice by eliminating aspirin after three months in patients on ticagrelor with resultant lower vascular bleeding and no effect on ischemic endpoints' said Samin K. Sharma, MD, Director of Clinical and Interventional Cardiology for the Mount Sinai Health System.

Source: https://www.news-medical.net/news/20190926/High-risk-heart-patients-may-not-require-long-term-aspirin-use-after-stent-placement.aspx
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