Safety and Efficacy of Ticagrelor With Low-dose Aspirin Versus Regular Aspirin in Patients With Acute Coronary Syndrome at High-risk for Ischemia After Percutaneous Coronary Intervention: A Randomized Controlled Study
The present study is aimed to compare the safety and efficacy of Ticagrelor with low-dose Aspirin versus standard dual anti-platelet therapy (DAPT) in patients with acute coronary syndrome (ACS) at high risk for ischemic events after percutaneous coronary intervention (PCI) and stent implantation.
• ACS patients at high risk for ischemic events after successful PCI with implantation of at least one drug eluting stent
• Able and willing to provide informed consent and participate in 12 months follow-up period
• Able to receive DAPT treatment
• Enrollment into the study will require meeting at least one angiographic or clinical inclusion and none of the exclusion criteria.
∙ Clinical inclusion criteria:
⁃ Family history of premature coronary heart disease (Coronary heart disease in first-degree male relative \<55 years old or in first-degree female relative \<65 years old)
⁃ Repeated myocardial infarction
⁃ Positive serum cardiac troponin I/T
⁃ Combined with at least one organ/system with atherosclerotic disease (e.g. intracranial or peripheral arteries)
⁃ Type 2 diabetes mellitus under medication
⁃ Chronic kidney disease (eGFR\<60 mL/min/1.73 m2 or CrCl\<60ml/min)
∙ Angiographic Inclusion Criteria:
⁃ LM lesion requiring stents
⁃ Proximal LAD lesion(s) requiring stents
⁃ Bypass grafts lesion(s) requiring stents
⁃ Overall stent length ≥60 mm
⁃ History of in-stent thrombosis
⁃ Bifurcation lesions requiring at least 2 stents
⁃ Over two vessels lesions requiring stents
⁃ Calcified target lesion(s) requiring atherectomy
⁃ The intraoperative occurrence of no-reflow or slow-flow
‣ Compressed branch vessels with a diameter of at least 2.0 mm failing to reach flow restoration (at least TIMI 3)