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Ticagrelor Monotherapy After PCI Across the Spectrum of TWILIGHT High-Risk Criteria. A deep dive into the TWILIGHT trial

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Johny Nicolas, MD

Dual antiplatelet therapy (DAPT), a combination of aspirin and a P2Y12 inhibitor, is the mainstay antithrombotic strategy after percutaneous coronary intervention (PCI). This combination has been proven superior to aspirin alone in preventing cardiovascular events after stent implantation, although at the expense of increased bleeding. Recently, the TWILIGHT trial showed that, as compared with prolonged DAPT, a short DAPT regimen followed by ticagrelor monotherapy effectively reduces bleeding without increasing ischemic events in high-risk patients undergoing PCI. Whether these benefits are preserved across different risk strata remains unknown.

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