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Gender differences among patients with high risk receiving ticagrelor after percutaneous coronary intervention

JAMA May 28, 2021

Vogel B, Baber U, Cohen DJ, et al. - By performing this prespecified secondary analysis of TWILIGHT (an investigator-initiated, placebo-controlled randomized clinical trial), researchers investigated gender disparities as well as the link of gender with results among patients managed with ticagrelor monotherapy vs ticagrelor plus aspirin. This study involved patients who had successful percutaneous coronary intervention (PCI) with drug-eluting stents, were planned for discharge with ticagrelor plus aspirin, and who exhibited at least 1 clinical and at least 1 angiographic feature related to high risk of ischemic or bleeding events. At 3 months post-PCI, randomization of patients adherent to ticagrelor and aspirin without major adverse events was done to receive either aspirin or placebo for an additional 12 months along with ticagrelor. Findings revealed that women, vs men, had a higher bleeding risk which was mostly because of baseline differences, whereas the noted ischemic events were similar between genders. Generally comparable advantages of early aspirin withdrawal with continuation of ticagrelor were evident between women and men in this high-risk PCI population.

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