• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

De-escalation with clopidogrel may reduce bleeding events in patients with recent percutaneous coronary intervention

byNeel MistryandTeddy Guo
October 19, 2021
in Cardiology, Chronic Disease
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. 12-months after randomization, the de-escalation group met the criteria for superiority (p=0.0001) with respect to the composite primary outcome of cardiovascular mortality, myocardial infarction, stroke, or bleeding.

2. Type 2, 3, or 5 bleeding was significantly less frequent in the clopidogrel group (3.0%) compared to ticagrelor group (5.6%).

Evidence Rating Level: 1 (Excellent)

Study Rundown: Antiplatelet therapy is used to mitigate the risk of recurrent thrombotic events. For this reason, ticagrelor and prasugrel – potent P2Y12 inhibitors – are preferred as immediate therapy following an acute myocardial infarction. However, given their mechanism of action, these medications may also increase one’s risk for bleeding events long term. As a result, a less potent substitute, such as clopidogrel, could be explored for long-term management. This randomized controlled trial aimed to identify the effectiveness of clopidogrel as an alternative dual antiplatelet therapy (DAPT) to ticagrelor for de-escalation one month following an acute myocardial infarction. The primary outcome for this study was the occurrence of cardiovascular death, myocardial infarction, stroke, and bleeding (type 2, 3, or 5 on the Bleeding Academic Research Consortium criteria) while key secondary outcomes included all-cause mortality. According to results, the de-escalation to clopidogrel group was found to meet the noninferiority and superiority criteria for the primary outcome. In addition, de-escalation to clopidogrel resulted in fewer instances of bleeding. This study was strengthened by a large sample size with an equal proportion of patients in each group.

Click to read the study in The Lancet

Relevant Reading: Ticagrelor with or without Aspirin in High-Risk Patients after PCI

RELATED REPORTS

Cerebral embolic protection does not decrease stroke incidence in TAVI patients

2 Minute Medicine Rewind July 7, 2025

#VisualAbstract: Routine Cerebral Embolic Protection Did Not Reduce Stroke Incidence during Transcatheter Aortic-Valve Implantation

In-depth [randomized controlled trial]: Between Feb 26, 2014, and Dec 31, 2018, 2901 patients from 32 institutes in South Korea were assessed for eligibility. Included patients were those with a successful percutaneous coronary intervention (PCI) and tolerance to aspirin and ticagrelor. Altogether, 2697 patients were enrolled (1349 to aspirin plus clopidogrel [de-escalation group] and 1348 to aspirin plus ticagrelor [control group]) and 2605 completed follow-up at 12 months. All patients received aspirin and ticagrelor up to 1-month post-myocardial infarction where they were then randomized 1:1 to continue ticagrelor or de-escalate to clopidogrel. Fewer cardiovascular deaths, myocardial infarctions, strokes, or bleeding events were reported in the clopidogrel group (4.6%) compared to the ticagrelor group (8.2%) at 12 months (hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.40-0.76, pnon-inferiority<0.001; psuperiority=0.0001). However, when looking at individual events, the only significant difference found was with type 2, 3, or 5 bleeding, which occurred less frequently in the clopidogrel group compared to ticagrelor (3.0% vs. 5.6%, HR 0.52, 95% CI 0.35-0.77, p=0.0012). Overall, findings from this study suggest that post-operative use of clopidogrel, compared to ticagrelor, may reduce bleeding events, and result in favorable clinical outcomes.

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: aspirinatherosclerosiscardiologycardiovascular eventscardiovascular mortalityclopidogrelCoronary artery diseasecoronary artery disease (CAD)myocardial infarction (MI)P2Y12 inhibitorPrasugrelTicagrelor
Previous Post

No significant differences in efficacy and safety between deutetrabenazine and placebo for the treatment of tics in Tourette syndrome in the pediatric population

Next Post

East Ventures to raise funds to produce Covid-19 test kits

RelatedReports

Cerebral protection device effective in patients undergoing transcatheter aortic valve implantation
Cardiology

Cerebral embolic protection does not decrease stroke incidence in TAVI patients

July 8, 2025
Weekly Rewinds

2 Minute Medicine Rewind July 7, 2025

July 10, 2025
#VisualAbstract: Routine Cerebral Embolic Protection Did Not Reduce Stroke Incidence during Transcatheter Aortic-Valve Implantation
All Specialties

#VisualAbstract: Routine Cerebral Embolic Protection Did Not Reduce Stroke Incidence during Transcatheter Aortic-Valve Implantation

July 3, 2025
The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: Celebrity diagnoses spur screenings, athlete mental-health push, reality-TV heart lesson, and a sitcom PSA wave

July 2, 2025
Next Post

East Ventures to raise funds to produce Covid-19 test kits

#VisualAbstract: Increasing the number of SARS-CoV-2 immune family members associated with decreasing risk of infection in nonimmune individuals

#VisualAbstract: Increasing the number of SARS-CoV-2 immune family members associated with decreasing risk of infection in nonimmune individuals

Added sugar intake associated with mortality from cardiovascular disease

Nonnutritive sweeteners elicit more neural response to food cues compared to sugar

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Inebilizumab improves outcome in patients generalized myasthenia gravis
  • Medbridge turns any phone into a motion-capture coach for at-home rehab
  • Structured exercise intervention improves survival in colon cancer patients
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.