Ticagrelor monotherapy after coronary stenting in patients requiring proton pump inhibitor and prolonged antiplatelet therapy.

Abstract

Key Points Approximately half of patients undergoing coronary stenting are discharged on a proton‐pump inhibitor (PPI). Post‐hoc analysis of the large GLOBAL LEADERs trial finds PPI treatment and aspirin monotherapy after a year of dual antiplatelet therapy (DAPT) is associated with increased risk of ischemic events. In contrast, PPI treatment and continued ticagrelor monotherapy are not associated with increased ischemic events in the second year after stenting. This observational evidence suggests the GLOBAL LEADERS tested ticagrelor monotherapy regimen could be considered in patients requiring both prolonged antiplatelet therapy (>12 months) and PPI for increased bleeding risk.