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双重抗血小板治疗持续时间

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A Prospective, Multicenter, Randomized, Open-label Trial to Compare Efficacy and Safety of Clopidogrel vs. Ticagrelor in Stabilized Patients with Acute Myocardial Infarction after Percutan eous Coronary Intervention: rationale and design of the TALOS-AMI trial Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry Benefit-risk profile of extended dual antiplatelet therapy beyond 1 year in patients with high risk of ischemic or bleeding events after PCI Pooled Analysis of Bleeding, Major Adverse Cardiovascular Events, and All-Cause Mortality in Clinical Trials of Time-Constrained Dual-Antiplatelet Therapy After Percutaneous Coronary Intervention Long-term dual antiplatelet-induced intestinal injury resulting in translocation of intestinal bacteria into blood circulation increased the incidence of adverse events after PCI in patients with coronary artery disease Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention Antibody-Based Ticagrelor Reversal Agent in Healthy Volunteers Ticagrelor Monotherapy Versus Ticagrelor With Aspirin in Patients With ST-Segment Elevation Myocardial Infarction Rivaroxaban Plus Aspirin Versus Aspirin in Relation to Vascular Risk in the COMPASS Trial Adjunctive Cilostazol to Dual Antiplatelet Therapy to Enhance Mobilization of Endothelial Progenitor Cell in Patients with Acute Myocardial Infarction: A Randomized, Placebo-Controlled EPISODE Trial
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Clinical Trial2020 Jul 28;EIJ-D-20-00187.

JOURNAL：Eurointervention. Article Link

A Prospective, Multicenter, Randomized, Open-label Trial to Compare Efficacy and Safety of Clopidogrel vs. Ticagrelor in Stabilized Patients with Acute Myocardial Infarction after Percutan eous Coronary Intervention: rationale and design of the TALOS-AMI trial

M-W Park, CJ Kim, K Chang et al. Keywords: clopidogrel vs. ticagrelor; AMI; BARC criteria from 1 to 12 months after the index PCI

ABSTRACT

AIMS - In patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), the risk of ischemic complications is highest in early phase (during the first 30days), while most bleeding events predominantly occur during maintenance phase of treatment (after the first 30days). Data on the de-escalating dual antiplatelet therapy of switching from ticagrelor to clopidogrel in stabilized AMI patients are limited.


METHODS AND RESULTS - The TALOS-AMI is a, multicenter, randomized, open-label study enrolling 2590 AMI patients with no adverse events during the first month after the index PCI. One month after the index PCI, eligible patients are randomly assigned either to the 1) aspirin 100 mg plus clopidogrel 75mg daily or 2) aspirin 100 mg plus ticagrelor 90 mg twice daily in a 1:1 ratio. The primary endpoint is a composite of cardiovascular death, MI, stroke, and bleeding type 2, 3 or 5 according to Bleeding Academic Research Consortium (BARC) criteria from 1 to 12 months after the index PCI.


CONCLUSIONS - The TALOS-AMI trial is the first large-scale, multicenter, randomized study exploring the efficacy and safety of the de-escalating antiplatelet therapy that switches ticagrelor to clopidogrel in stabilized AMI patients undergoing PCI.

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