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Ticagrelor in diabetic patients reduces CV events but increases major bleeding

Expert
Dr Deepak Bhatt, Harvard Medical School, USA
Conference
ESC 2019
Results from the large THEMIS trial demonstrated that the combination ticagrelor/aspirin is associated with a reduction in cardiovascular events in diabetic patients. However, patients on ticagrelor experienced an increase in major bleeding compared with those using only aspirin. The 10trial –one of the largest studies on diabetes/antithrombotic treatment– evaluated the effects of the antiplatelet ticagrelor + low-dose aspirin (n=9,619) vs placebo + aspirin only (n=9,601) for secondary cardiovascular prevention in patients with type 2 diabetes and stable coronary artery disease [1]. This was defined as a history of percutaneous coronary intervention (PCI), bypass grafting, or angiographic stenosis of 50% or more in at least one coronary artery. Patients with known prior myocardial infarction or stroke were excluded. The trial enrolled 19,220 patients at 1,315 sites across 42 countries in North America, South America, Asia, Africa, Australia, and Europe. Me...


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