NEW RESEARCH PAPER

P2Y12 Inhibitor
Monotherapy
Combined With
Colchicine
Following PCI
in ACS Patients
Table Of Contents
1 BACKGROUND

2 METHODOLOGY

3 STUDY OUTCOME

4 RESULTS

5 DISSCUSSION

6 CONCLUSION
BACKGROUND

Standard Care: High-risk heart patients with

conditions like ACS undergoing a heart
procedure (PCI) receive dual antiplatelet
therapy (DAPT) – aspirin + P2Y12 inhibitor.
This stops harmful blood clots
Safety & Effectiveness Balance: To be safer yet
effective, studies propose halting aspirin after
1-3 months of DAPT and sticking with the
P2Y12 inhibitor. This cuts bleeding risk without
upping clotting risk.
Modified Strategy: Research shows that
stopping aspirin after 1-3 months of DAPT and
staying with the P2Y12 inhibitor reduces major
bleeding risk without raising clotting risk
BACKGROUND
Factors Impacting Risk: Clotting risk depends on
factors like the type of P2Y12 inhibitor used (like
ticagrelor/prasugrel vs. clopidogrel), the patient's
condition (ACS vs. stable heart disease), and the
complexity of heart disease or procedure..
Anti-Inflammation Possibility-Colchicine, studied in
ACS patients, might work best when started early in
the hospital.
New Strategy Testing-This study aimed to see if using
ticagrelor/prasugrel (P2Y12 inhibitors) without aspirin,
combined with colchicine right after PCI in ACS
patients, is safe and effective. Goal: Cut both recurring
heart issues and bleeding risk.
 Methodology

Study Design: The

Population: Patients
MACT study was a Procedures: After PCI, Monitoring: Platelet
with specific heart
single-center, single- patients were given function testing and hs-
conditions and
arm pilot trial aspirin and either CRP measurements were
undergoing PCI with
(NCT04949516) similar ticagrelor or prasugrel. done. Follow-up visits
drug-eluting stents
to the ASET trial. It Aspirin was stopped, occurred at 1 and 3
were included. Some
explored a new and colchicine was months, tracking
patients with certain
approach for ACS introduced along with symptoms, treatment,
conditions were
patients after heart ticagrelor/prasugrel. and events.
excluded.
procedures.
 STUDY OUTCOMES
This study aimed to check if using only ticagrelor or prasugrel
(P2Y12 inhibitors) without aspirin, along with colchicine, right
after PCI in ACS patients is safe and effective.
The goal is to find a way to reduce the risk of both recurring
heart issues and bleeding after a heart procedure

 ADHERENCE TO STUDY MEDICATIONS
AND SERIOUS ADVERSE EVENTS-
 After discharge:
 99.0% (198 out of 200) followed the
study procedure.
 At 1 month: 98.5% (197 out of 200)
attended clinical follow-up.
 97.0% (191 out of 197) continued the
study procedure.
 By 3 months:95.0% (190 out of 200)
completed clinical follow-up.
Result
 Primary outcome: Seen in 2
patients.
 Case 1 (5 days post-index
procedure):  Lab Measurements:
 Procedure: 2.75 × 38 mm  Platelet Reactivity: Discharge level
amphilimus-eluting stent (Cre8, CID
27 ± 42 PRUs (from 191 patients).
SpA) for ST-segment elevation MI.  LPR: 91.1% had low platelet
 Medication: Aspirin, ticagrelor (242
reactivity (LPR).
PRUs) at discharge.  HPR: 0.5% showed high platelet
 Outcome: Treated subacute stent
reactivity (HPR) (Figure 2A).
thrombosis with balloon  Similarity: Platelet reactivity similar
angioplasty.
in ticagrelor and prasugrel users (P =
0.65) (Figure 2B).
 Case 2 (8 days post-index  Inflammation: Markedly reduced
procedure):
over time.
 Procedure: 2.75 × 30 mm sirolimus-
eluting stent (Orsiro, Biotronik AG)
for ST-segment elevation MI.
 Medication: Ticagrelor, LPR at
discharge.
DISCUSSION
This study is the first to assess P2Y12 inhibitor
monotherapy with ticagrelor or prasugrel, along with
colchicine, in ACS patients after PCI. Key findings:
 ACS patients on ticagrelor/prasugrel + low-dose
colchicine had low stent thrombosis (1.0%) and
major bleeding (0.5%) rates at 3 months.
 Majority exhibited low platelet reactivity (LPR), only
0.5% had high reactivity (HPR).
 Inflammation decreased rapidly within a month,
with lower hs-CRP levels.
 Immediate aspirin discontinuation could reduce
major bleeding risk, backed by previous studies.
 Colchicine's anti-inflammatory and platelet
inhibition potential offers benefits for ACS patients.
CONCLUSIONS
 Feasibility of stopping aspirin and using
low-dose colchicine post-PCI with
ticagrelor/prasugrel.
 Improvements seen in platelet function
and inflammation profiles.
Thank You!