Ticagrelor monotherapy as a strategy to reduce the bleeding risk in patients with acute coronary syndrome who underwent percutaneous coronary intervention
https://doi.org/10.15829/1560-4071-2025-6482
EDN: YNPEON
Abstract
It is known that the risk of thrombotic events in patients with acute coronary syndrome (ACS) is highest in the first year after the event. Regardless of the treatment tactics, dual antiplatelet therapy (DAPT) is prescribed for a year after. DAPT significantly prevents thrombotic events, primarily recurrent myocardial infarction. At the same time, the bleeding risk naturally increases. In recent years, convincing data have been obtained that the transition from DAPT to ticagrelor monotherapy 1-3 months after the event leads to a significant reduction in the bleeding risk without increasing the rate of thrombotic events compared to 12-month DAPT. The review analyzes data from randomized clinical trials comparing DAPT and ticagrelor monotherapy in patients with ACS and presents the provisions of Russian and international clinical guidelines for the treatment of ACS regarding ticagrelor monotherapy. The review aim is to rationale the advantage of ticagrelor monotherapy compared to standard DAPT in patients with ACS and percutaneous coronary intervention using a detailed analysis of randomized controlled trials and meta-analyses. The practical part presents the relevant sections of the clinical guidelines.
About the Authors
Yu. O. Shalaginova
Chazov National Medical Research Center of Cardiology
Russian Federation
Russian Federation
Yuliya O. Shalaginova — Candidate of Medical Sciences
Moscow
R. M. Shakhnovich
Chazov National Medical Research Center of Cardiology
Russian Federation
Russian Federation
Roman M. Shakhnovich — Institute for training of higher qualification staff, professor at the Department of Emergency Cardiology, Doctor of Medical Sciences
Moscow
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Review
For citations:
Shalaginova Yu.O., Shakhnovich R.M. Ticagrelor monotherapy as a strategy to reduce the bleeding risk in patients with acute coronary syndrome who underwent percutaneous coronary intervention. Russian Journal of Cardiology. 2025;30(9):6482. (In Russ.) https://doi.org/10.15829/1560-4071-2025-6482. EDN: YNPEON
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