Aspirin-free Strategy With Ticagrelor in Patients With a Myocardial Infarction Treated Medically Alone

Summary

In patients with a myocardial infarction (MI) treated medically alone, the objective of the PANTHEON trial is to evaluate if ticagrelor monotherapy reduces bleeding events, without an increase in patient-oriented ischemic events, compared with standard dual antiplatelet therapy (DAPT) with aspirin and ticagrelor for 12 months.

Eligibility

Inclusion criteria:

* Age ≥18 years;
* Hospitalized for type 1 MI, according to the 4th Universal Definition of MI;
* Coronary angiogram performed;
* Planned for medical management alone, without revascularization;
* Willingness to participate and to attend study visits;
* Expected life expectancy ≥12 months.

Exclusion criteria:

* Patients hospitalized for type 2-5 MI, or unstable angina, according to the 4th Universal Definition of MI;
* Patients hospitalized for a STEMI with an acute thrombotic lesion of a major epicardial vessel;
* Elevations in cardiac biomarkers (troponins or CK-MB) that is believed by the investigator not to be of ischemic origin (e.g. myocardial injury, myocarditis, Takotsubo syndrome, etc.);
* Confirmed or suspected spontaneous coronary artery dissection;
* Concomitant indication for chronic oral anticoagulant;
* Concomitant non-coronary indication for dual antiplatelet therapy;
* Use of any non-trial antiplatelet drug that needs to be continued based on the judgement of the treating physician;
* Previous hospitalization for MI, PCI, or CABG within 12 months;
* Known hypersensitivity, intolerance, or contra-indication to ASA or ticagrelor;
* Unsuitability for either randomization treatment, based on the judgement of the treating physician

Conditions4

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