Objective
to assess the efficacy and safety of de-escalation; without a loading dose of clopidogrel, from ticagrelor to clopidogrel in stabilised post PCI AMI patients
Study
investigator-initiated multicentre non-inferiority randomised trial (margin HR 1.34). If non-inferiority was met its superiority was subsequently tested.
Population
patients with successful primary PCI, stabilised and without MACE or bleeding during 1 month after AMI receiving aspirin and ticagrelor
Endpoints
composite of cardiovascular death, MI, stroke or bleeding (BARC: 2, 3 or 5)
Conclusion
de-escalation from ticagrelor (+ aspirin) to clopidogrel (+aspirin) significantly reduced major adverse events during 1 to 12 months in stabilised post PCI AMI patients
Kim et al. Lancet. 2021;398:1305-16