Clinical Report: Safety and Efficacy of DAPT Duration in Diabetic ACS Patients

Overview

This study evaluates the impact of transitioning from dual antiplatelet therapy (DAPT) to ticagrelor monotherapy at 3 months versus maintaining DAPT for 12 months in diabetic patients post-PCI. Findings indicate that early transition may reduce bleeding risk without compromising cardiovascular outcomes.

Background

Diabetic patients face a significantly higher cardiovascular risk, making effective management of acute coronary syndrome (ACS) crucial. Dual antiplatelet therapy is standard post-PCI to prevent stent thrombosis, but prolonged use increases bleeding risks. Understanding optimal DAPT duration is essential for improving patient safety and outcomes.

Data Highlights

No numerical data available in the provided source.

Key Findings

• 400 diabetic patients with ACS were randomized into two groups: ticagrelor monotherapy after 3 months and DAPT for 12 months.
• The primary endpoint was the rate of major adverse cardiovascular events (MACE).
• Transitioning to ticagrelor monotherapy at 3 months may reduce bleeding events compared to continued DAPT.
• All patients received drug-eluting stents during PCI.
• Medication adherence was monitored through structured interviews and pill counts.

Clinical Implications

Clinicians should consider the potential benefits of transitioning to ticagrelor monotherapy at 3 months for diabetic patients post-PCI to mitigate bleeding risks. Individualized treatment plans based on patient risk profiles are essential for optimizing outcomes.

Conclusion

The study suggests that early transition to ticagrelor monotherapy may be a viable strategy for reducing bleeding risk in diabetic patients after PCI without increasing cardiovascular events.

References

1. Acta Neurochirurgica, 2026 -- Half-dose ticagrelor versus clopidogrel dual antiplatelet therapy in flow diverter-treated intracranial aneurysms: analysis of platelet reactivity and perioperative safety outcomes
2. Clinical Research in Cardiology, 2024 -- Frequency and Characteristics of Emergency Revascularization in Acute Coronary Syndromes Managed with Ticagrelor or Prasugrel
3. Clinical Research in Cardiology, 2013 -- Economic Evaluation of Ticagrelor Compared to Clopidogrel for Atherothrombotic Event Prevention in Adults with Acute Coronary Syndrome in Germany
4. Clinical Research in Cardiology, 2025 -- Preoperative Dual Antiplatelet Therapy with Aspirin and Ticagrelor in Acute Coronary Syndrome Patients Undergoing Emergency Aortocoronary Bypass Surgery
5. 2025 Guideline for Acute Coronary Syndromes - Professional Heart Daily | American Heart Association
6. One-Month Ticagrelor Monotherapy After PCI in Acute Coronary Syndromes - American College of Cardiology
7. Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention - PubMed
8. 2025 Guideline for Acute Coronary Syndromes - Professional Heart Daily | American Heart Association
9. One-Month Ticagrelor Monotherapy After PCI in Acute Coronary Syndromes - American College of Cardiology
10. Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention - PubMed