Oklahoma City -- Usman Baber, M.D., OU Medicine interventional cardiologist, presented findings of a recent study of patients at elevated risk for secondary myocardial infarction, during the 2020 Society for Cardiovascular Angiography and Interventions Scientific Sessions.
The annual conference, held virtually for the first time, is an international forum for the advancement of interventional cardiology research and practice. TCTMD, a publication of the Cardiovascular Research Foundation, included highlights of Baber’s presentation and his comments on the study in a related article, which appeared in the May 2020 issue.
The TWILIGHT trial compared patients at elevated risk for secondary myocardial infarction assigned to ticagrelor (Brilinta) monotherapy, to another group using ticagrelor plus aspirin, irrespective of what type of drug-eluting stents were used. Baber said the study was designed to determine if the type of stent influenced the benefit-risk ratio of ticagrelor monotherapy following percutaneous coronary intervention (PCI). PCI, also known as coronary angioplasty, is a nonsurgical procedure that improves blood flow to the heart.
“Monotherapy – or discontinued use of aspirin – decreased clinically relevant bleeding without increasing the death rate, risk of thrombotic events (blood clots), myocardial infarction or stroke,” said Baber, who is also medical director of OU Medicine catheterization lab. He explained that these incidents were not significantly variable between patients with the Synergy device and the conventional durable polymer stent. “The selected stenting platform is not a critical factor in this regard.”
The study found that target lesion failure, an aggregate measure that encompasses cardiac death, target vessel MI, vessel revascularization or stent thrombosis at 15 months, was significantly reduced when aspirin was discontinued soon after PCI.
Dwight W. Reynolds, M.D., chief of the section of Cardiology, University of Oklahoma College of Medicine, commended the work of Baber and emphasized the importance of the TWILIGHT study. “These findings are significant in the field of interventional cardiology. Percutaneous coronary intervention/angioplasty is a procedure with 40 years of history. Through studies like this, its evolution has advanced to allow a better balance between precision medicine and personalized therapies, with improved patient outcomes as a result.”
In addition to publication in TCTMD, Baber’s SCAI presentation was prominently featured in MedPageToday and Helio/Cardiology Today.