La Dra. María López Lluva analiza los resultados del estudio publicado en ACC Congress 2020.

1. The TICO Trial María Thiscal López Lluva
Ticagrelor With or Without Aspirin In Acute
Coronary Syndrome After PCI
Randomized Evaluation Of Ticagrelor Monotherapy After 3-month Dual-antiplatelet
Therapy In Acute Coronary Syndrome
The TICO Trial

2. The TICO Trial María Thiscal López Lluva
OBJECTIVE
To test whether ticagrelor monotherapy after 3-month DAPT improved upon ticagrelor-based 12 month DAPT for
ACS undergoing PCI with ultrathin bioresorbable polymer sirolimus-eluting stents (Orsiro®) in terms of net adverse
clinical events (NACE) combining the risks of ischemia and bleeding
STUDY DESIGN
Prospective, randomized, multi-center (38 centers in Korea)
Exclusion criteria: 1) age > 80, 2) increased risk of bleeding,
3) need of OAC, 4) current or potential pregnancy, 5) hepatic
dysfunction and 6) increased bradycardia-related symptoms
NACE: Net Adverse Clinical Events
TIMI-major bleeding
+
Major adverse cardiac and
cerebrovascular events (MACCE)
(All-cause death, MI, stent
thrombosis, stroke or TVR)
Kim C. Am Heart J. 2019;212:45–52

3. The TICO Trial María Thiscal López Lluva
Kim C.
Am Heart J. 2019;212:45–52

4. The TICO Trial María Thiscal López Lluva

5. The TICO Trial María Thiscal López Lluva

6. The TICO Trial María Thiscal López Lluva
NACE at 12 months (Net Adverse Clinical Events) NACE at 12 months (TIMI-major bleeding + MACCE)

7. The TICO Trial María Thiscal López Lluva
NACE at 12 months (Net Adverse Clinical Events) NACE at 12 months (TIMI-major bleeding + MACCE)NACE at 12 months (TIMI-major bleeding + MACCE)

8. The TICO Trial María Thiscal López Lluva
Clinical outcomes at 12 months

9. The TICO Trial María Thiscal López Lluva
CONCLUSIONS
Among patients treated with ultrathin biodegradable polymer sirolimus eluting stents for ACS:
- Ticagrelor monotherapy after 3-month DAPT showed a significantly lower risk of net adverse clinical events
than currently recommended ticagrelor-based 12-months DAPT (reduced risk was mainly due to decreased major
bleeding).
- This finding indicates that ticagrelor monotherapy could be an optimal strategy, balancing both ischemic and
bleeding risk for patients with ACS treated by ultrathin biodegradable polymer SES