University of Hertfordshire

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  • Jacek Kubica
  • Piotr Adamski
  • Piotr Niezgoda
  • Aldona Kubica
  • Przemysław Podhajski
  • Malwina Barańska
  • Julia M. Umińska
  • Łukasz Pietrzykowski
  • Małgorzata Ostrowska
  • Jolanta M. Siller-Matula
  • Jolita Badarienė
  • Stanisław Bartuś
  • Andrzej Budaj
  • Sławomir Dobrzycki
  • Łukasz Fidor
  • Mariusz Gąsior
  • Jacek Gessek
  • Marek Gierlotka
  • Robert Gil
  • Jarosław Gorący
  • Paweł Grzelakowski
  • Tomasz Hajdukiewicz
  • Miłosz Jaguszewski
  • Marianna Janion
  • Jarosław Kasprzak
  • Adam Kern
  • Artur Klecha
  • Andrzej Kleinrok
  • Wacław Kochman
  • Bartosz Krakowiak
  • Jacek Legutko
  • Maciej Lesiak
  • Marcin Nosal
  • Grzegorz Piotrowski
  • Andrzej Przybylski
  • Tomasz Roleder
  • Grzegorz Skonieczny
  • Grzegorz Sobieszek
  • Agnieszka Tycińska
  • Dariusz Wojciechowski
  • Wojciech Wojakowski
  • Jarosław Wójcik
  • Marzenna Zielińska
  • Aleksander Żurakowski
  • Giuseppe Specchia
  • Eliano P. Navarese
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Original languageEnglish
Pages (from-to)607-614
Number of pages8
JournalCardiology Journal
Volume28
Issue4
Early online date2 Jun 2021
DOIs
Publication statusE-pub ahead of print - 2 Jun 2021

Abstract

The risk of ischemic events gradually decreases after acute coronary syndrome (ACS), reaching a stable level after 1 month, while the risk of bleeding remains steady during the whole period of dual antiplatelet treatment (DAPT). Several de-escalation strategies of antiplatelet treatment aiming to enhance safety of DAPT without depriving it of its efficacy have been evaluated so far. We hypothesized that reduction of the ticagrelor maintenance dose 1 month after ACS and its continuation until 12 months after ACS may improve adherence to antiplatelet treatment due to better tolerability compared with the standard dose of ticagrelor. Moreover, improved safety of treatment and preserved anti-ischemic benefit may also be expected with additional acetylsalicylic acid (ASA) withdrawal. To evaluate these hypotheses, we designed the Evaluating Safety and Efficacy of Two Ticagrelor-based De-escalation Antiplatelet Strategies in Acute Coronary Syndrome — a randomized clinical trial (ELECTRA-SIRIO 2), to assess the influence of ticagrelor dose reduction with or without continuation of ASA versus DAPT with standard dose ticagrelor in reducing clinically relevant bleeding and main-taining anti-ischemic efficacy in ACS patients. The study was designed as a phase III, randomized, multicenter, double-blind, investigator-initiated clinical study with a 12-month follow-up.

Notes

© 2021 Via Medica. This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license. https://creativecommons.org/licenses/by/4.0/

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