The following is a summary of the “Ticagrelor monotherapy after a short course of dual antiplatelet therapy with ticagrelor plus aspirin following percutaneous coronary intervention in patients with versus without diabetes mellitus: a meta-analysis of randomized trials,” published in the March 2024 issue of Cardiology by Ning et al.

Cardiovascular disease (CVD) remains a leading cause of global mortality, prompting various antiplatelet regimens post-percutaneous coronary intervention (PCI). This meta-analysis aims to delineate adverse clinical outcomes associated with ticagrelor monotherapy following a brief dual antiplatelet therapy (DAPT) course with ticagrelor and aspirin in patients with and without diabetes mellitus (DM).

Between September and November 2023, four authors systematically searched electronic databases for relevant studies. Cardiovascular outcomes and bleeding events were focal points analyzed using Revman 5.4 software. Risk ratios (RR) with 95% CI were computed for outcome representations.

Three studies, comprising 22,574 participants enrolled from 2013 to 2019, were included. Findings revealed DM correlated significantly with elevated risks of major adverse cardiovascular events (RR: 1.73, 95% CI: 1.49–2.00; P = 0.00001), all-cause mortality (RR: 2.15, 95% CI: 1.73–2.66; P = 0.00001), cardiac death (RR: 2.82, 95% CI: 1.42–5.60; P = 0.003), stroke (RR: 1.78, 95% CI: 1.16–2.74; P = 0.009), myocardial infarction (RR: 1.63, 95% CI: 1.17–2.26; P = 0.004), and stent thrombosis (RR: 1.74, 95% CI: 1.03–2.94; P = 0.04) compared to non-DM patients. However, thrombolysis in myocardial infarction (TIMI)-defined minor and major bleedings, along with bleeding defined by academic research consortium (BARC) type 3c (RR: 1.31, 95% CI: 0.14–11.90; P = 0.81) and BARC type 2, 3, or 5 (RR: 1.17, 95% CI: 0.85–1.62; P = 0.34), did not significantly differ.

In patients undergoing ticagrelor monotherapy post-brief DAPT with ticagrelor and aspirin, DM emerges as an independent risk factor for heightened adverse cardiovascular outcomes. However, there were no significant differences in TIMI and BARC-defined bleeding events between patients with and without DM.

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-03836-9