Trials of prolonged duration of antithrombotics
| Study | No. of patients | Agent used | Follow-up duration | Efficacy endpoints | Safety endpoint |
| PEGASUS 2015 ACS in previous 1–3 years with high ischaemia risk | 21 162 | Aspirin+Ticagrelor 60mg two times a day vs Aspirin+Ticagrelor 90mg two times a day vs Aspirin+placebo | 33 months | Death/MI/stroke Ticagrelor 90mg: 7.85% 60mg 7.77 % Placebo: 9.04 % P<0.001 | TIMI major bleeding 90mg: 2.6% 60mg: 2.3% Placebo:1.06% |
| THEMIS 2019 Stable CAD and type 2 diabetes, no history of previous MI/Stroke | 19 220 | Ticagrelor (60 two times a day)+Aspirin vs Aspirin+placebo | 39.9 months | Primary end point: CV death/MI/stroke Ticagrelor+Aspirin = 7.7% Aspirin+placebo = 8.1% p=0.038 | TIMI major bleeding Ticagrelor+Aspirin = 2.2% Aspirin+placebo = 1.0% P<0.001 |
| THEMIS-PCI 2019 Subgroup of THEMIS patients who underwent PCI | 11 154 | Ticagrelor (60 two times a day)+Aspirin vs Aspirin+placebo | Primary end point: CV death/MI/stroke Ticagrelor+Aspirin=7.3% Aspirin+placebo=8.6% P=0.013 | TIMI major bleeding Ticagrelor+Aspirin=2.0% Aspirin+placebo=1.1% P<0.001 Net clinical benefit: 15% reduction in Ticagrelor arm | |
| DAPT 2014 ACS with high ischaemia risk | 9961 | Aspirin+thienopyridine for 12 months vs Aspirin+thienopyridine for 30 months | 30 months | Stent thrombosis, 0.4%–30 months 1.4%–12 months death/MI/stroke 4.3%–30 months 5.9%–12 months P<0.001 | Moderate–severe bleeding 30 months—2.5% 12 months—1.6% P<0.001 |
| COMPASS 2017 Stable atherosclerotic vascular disease | 27 395 | Rivoraxaban 2.5 mg two times a day+Aspirin vs Rivoraxaban 5 mg two times a day vs Aspirin | 23 months | Death/MI/Stroke 4.1% (Rivaroxaban+Aspirin) 4.9% Rivoraxaban 5.4% Aspirin P<0.001 for (R+A) vs A | Major bleeding 3.1%—(Rivaroxaban+Aspirin) 1.9%—Aspirin P<0.001 |
DAPT, dual antiplatelet therapy; TIMI, Thrombolysis in Myocardial Infarction.