{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:53:35Z","timestamp":1760162015875,"version":"3.41.2"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Coronary stent type and risk of stent thrombosis remain important factors affecting recommended duration of dual antiplatelet therapy. We investigated the efficacy and safety of long\u2010term ticagrelor in patients with prior coronary stenting enrolled in the PEGASUS\u2010TIMI 54 (Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin\u2013Thrombolysis in Myocardial Infarction 54) trial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients in PEGASUS\u2010TIMI 54 had a myocardial infarction 1 to 3\u00a0year prior and were randomized 1:1:1 to ticagrelor 60 or 90\u00a0mg BID or placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, or stroke (major adverse cardiovascular events). Stent thrombosis was prospectively adjudicated (Academic Research Consortium definition). Baseline characteristics were compared by most recent stent type (bare metal versus drug\u2010eluting stent and first\u2010 versus later\u2010generation drug\u2010eluting stent). Treatment arms were compared using Cox proportional hazards models. Of 21\u00a0162 patients randomized, 80% (n=16\u00a0891) had prior coronary stenting. Following randomization, myocardial infarction was the most frequent ischemic event in patients with prior stenting in the placebo arm, occurring in 5.2% of patients (Type 1: 4.1%), followed by cardiovascular death (2.3%), stroke (1.7%), and stent thrombosis (0.9%). Ticagrelor\n              <jats:sub>pooled<\/jats:sub>\n              reduced major adverse cardiovascular events (7.0% versus 8.0%; hazard ratio [HR], 0.85; 95% CI, 0.75\u201396) regardless of stent type (bare metal stent versus drug\u2010eluting stent: p\n              <jats:sub>interaction<\/jats:sub>\n              =0.767; first versus later generation: p\n              <jats:sub>interaction<\/jats:sub>\n              =0.940). The rate of any stent thrombosis was numerically lower with ticagrelor\n              <jats:sub>pooled<\/jats:sub>\n              (0.7% versus 0.9%; HR, 0.73; 95% CI, 0.50\u20131.05) and Thrombolysis in Myocardial Infarction major bleeding was increased (HR, 2.65; 95% CI, 1.90\u20133.68).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Long\u2010term ticagrelor reduces major adverse cardiovascular events in patients with prior myocardial infarction and coronary stenting regardless of stent type, with the benefit driven predominantly by reduction in de novo events. Nonfatal major bleeding is increased with ticagrelor.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration Information<\/jats:title>\n            <jats:p xml:lang=\"en\">clinicaltrials.gov. Identifier: NCT01225562.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020446","type":"journal-article","created":{"date-parts":[[2021,8,21]],"date-time":"2021-08-21T09:11:22Z","timestamp":1629537082000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Long\u2010Term Ticagrelor in Patients With Prior Coronary Stenting in the PEGASUS\u2010TIMI 54 Trial"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4360-7606","authenticated-orcid":false,"given":"Brian A.","family":"Bergmark","sequence":"first","affiliation":[{"name":"TIMI Study Group Cardiovascular Medicine Department of Medicine Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":false,"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"TIMI Study Group Cardiovascular Medicine Department of Medicine Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. Gabriel","family":"Steg","sequence":"additional","affiliation":[{"name":"French Alliance for Cardiovascular TrialsAP\u2010HPH\u00f4pital BichatUniversit\u00e9 de ParisInstitut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U\u20101148 Paris France"},{"name":"National Heart and Lung InstituteRoyal Brompton HospitalImperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6395-2098","authenticated-orcid":false,"given":"Andrzej","family":"Budaj","sequence":"additional","affiliation":[{"name":"Centre of Postgraduate Medical Education Grochowski Hospital Warsaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-6229","authenticated-orcid":false,"given":"Robert F.","family":"Storey","sequence":"additional","affiliation":[{"name":"University of Sheffield Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yared","family":"Gurmu","sequence":"additional","affiliation":[{"name":"TIMI Study Group Cardiovascular Medicine Department of Medicine Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia F.","family":"Kuder","sequence":"additional","affiliation":[{"name":"TIMI Study Group Cardiovascular Medicine Department of Medicine Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KyungAh","family":"Im","sequence":"additional","affiliation":[{"name":"TIMI Study Group Cardiovascular Medicine Department of Medicine Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Magnani","sequence":"additional","affiliation":[{"name":"University Hospital of Parma Parma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ton","family":"Oude Ophuis","sequence":"additional","affiliation":[{"name":"Canisius\u2010Wilhelmina Hospital Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Hamm","sequence":"additional","affiliation":[{"name":"Kerckhoff Heart CenterBad NauheimUniversity of Giessen Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jind\u0159ich","family":"\u0160pinar","sequence":"additional","affiliation":[{"name":"University hospital St. Ann, Pekarska and Medical faculty Brno Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert G.","family":"Kiss","sequence":"additional","affiliation":[{"name":"Department of Cardiology Military Hospital Budapest Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9479-7767","authenticated-orcid":false,"given":"Frans J.","family":"Van de Werf","sequence":"additional","affiliation":[{"name":"University of Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0824-6809","authenticated-orcid":false,"given":"Gilles","family":"Montalescot","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, Paris 6ACTION Study GroupINSERM\u2010UMRS 1166Institut de CardiologiePiti\u00e9\u2010Salp\u00eatri\u00e8re Hospital (AP\u2010HP) Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9802-4147","authenticated-orcid":false,"given":"Per","family":"Johanson","sequence":"additional","affiliation":[{"name":"AstraZeneca M\u00f6lndal Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3472-626X","authenticated-orcid":false,"given":"Eugene","family":"Braunwald","sequence":"additional","affiliation":[{"name":"TIMI Study Group Cardiovascular Medicine Department of Medicine Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0691-3359","authenticated-orcid":false,"given":"Marc S.","family":"Sabatine","sequence":"additional","affiliation":[{"name":"TIMI Study Group Cardiovascular Medicine Department of Medicine Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9860-3584","authenticated-orcid":false,"given":"Marc P.","family":"Bonaca","sequence":"additional","affiliation":[{"name":"TIMI Study Group Cardiovascular Medicine Department of Medicine Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"},{"name":"Colorado Prevention Center (CPC) Clinical Research the Department of Medicine Division of Cardiovascular Medicine University of Colorado Anschutz Medical Campus Aurora CO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.03.025"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa060989"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200933"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709118"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409312"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500857"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112277"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044598"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.03.513"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.12.020"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.685313"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz821"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019861"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1002358"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.09.009"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.070"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.09.037"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1908077"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz707"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31887-2"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.12.062"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.04.022"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.05.064"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.8145"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.02.015"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1908419"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.08.1038"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-19-00131"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31858-0"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.046251"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30801-8"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30474-X"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.06.061"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.034309"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvz020"},{"key":"e_1_3_1_37_2","unstructured":"European Medicines Agency . Brilique (ticagrelor). 2011. Accessed June 5th 2020. https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/brilique"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.05.005"},{"key":"e_1_3_1_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61444-5"},{"key":"e_1_3_1_41_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu278"},{"key":"e_1_3_1_42_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011245"},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.12.012"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.020446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:44:13Z","timestamp":1715600653000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.020446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,7]]},"references-count":42,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2021,9,7]]}},"alternative-id":["10.1161\/JAHA.120.020446"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.020446","relation":{},"ISSN":["2047-9980"],"issn-type":[{"type":"electronic","value":"2047-9980"}],"subject":[],"published":{"date-parts":[[2021,9,7]]},"assertion":[{"value":"2021-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e020446"}}