Efficacy and Safety of Ticagrelor Monotherapy in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Retrospective Study

Background: Dual antiplatelet therapy (DAPT) is the standard treatment for percutaneous coronary intervention (PCI), but its optimal duration is controversial. Ticagrelor monotherapy has obvious advantages in reducing the bleeding risk, so this study investigated its efficacy and safety. Objective: The objective of this study was to explore the efficacy and safety of administering ticagrelor monotherapy to patients with acute coronary syndrome (ACS) undergoing PCI. Methods: This retrospective study chose 110 patients with ACS undergoing PCI from January 2022 to April 2024. In accordance with different antiplatelet therapy methods, 58 patients received DAPT of ticagrelor and aspirin, and 54 cases were included in the control group (CG) after excluding 4 cases. Meanwhile, 52 cases received ticagrelor monotherapy after 3 months of DAPT, and 49 cases were classified as the observation group (OG) after excluding 3 cases. The platelet inhibition rates, platelet aggregation functions, and adverse events before and after treatment were compared. Results: Intergroup comparison showed no significant difference in adenosine diphosphate-induced platelet inhibition rates 3 months (T1) and 6 months (T2) after operation (p = 0.129, 0.137), and the inhibition rate in OG was significantly lower than that in CG 12 months (T3) after operation (p < 0.001). At T1, T2, and T3, no significant difference in fibrinogen and prothrombin time was found (p = 0.112, 0.751, 0.590, 0.771, 0.109, 0.121). After 12-month follow-up, intergroup comparison revealed no significant difference in the incidence of ischemic events (OG vs. CG: 4.08% vs. 9.26%; p = 0.515) and a significantly lower incidence of bleeding events in OG than in CG (OG vs. CG: 4.08% vs. 18.52%; p = 0.023). Conclusion: Administering ticagrelor monotherapy after short-term DAPT (three months) to patients with ACS undergoing PCI effectively controlled the platelet inhibition rate, reduced bleeding events, and did not increase the risk of ischemic events.