Conference Coverage
SAN DIEGO – Current guidelines call for treating acute coronary syndrome patients with dual antiplatelet therapy (aspirin plus a thienopyridine) for at least 1 year following their event, but results from recent large, randomized trials suggest that many patients continue to benefit from treatment that extends beyond the first year, Dr. Richard C. Becker said during an interview at the annual meeting of the American College of Cardiology.
New results reported at the meeting from the PEGASUS-TIMI (Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction) 54 trial highlight the long-term risk for ischemic events faced by patients following an acute coronary syndrome (N. Engl. J. Med. 2025;[doi: 10.1056/NEJMoa0904327]. The results also underscore the importance of risk assessment, and the importance of tailoring treatment to ACS patients based not only on their long-term risk from their cardiovascular disease but also their risk for adverse bleeding events secondary to prolonged, aggressive antiplatelet therapy. The PEGASUS-TIMI 54 results complement the findings reported last year from the DAPT (Dual Antiplatelet Therapy) trial (N. Engl. J. Med. 2014;371:2155-66), he said.
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Based on the accumulated evidence, ACS patients who have done well clinically on DAPT after 1 year and are deemed at low risk for bleeding and other complications are good candidates for more prolonged DAPT treatment, said Dr. Becker, professor and director of the University of Cincinnati Heart, Lung & Vascular Institute.
PEGASUS-TIMI 54 ws sponsored by AstraZeneca, which markets ticagrelor (Brilinta). Dr. Becker has been a consultant to and received research support from AstraZeneca.
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