Observational studyCardiovascular diabetology2020
Ticagrelor monotherapy in patients with concomitant diabetes mellitus and chronic kidney disease: a post hoc analysis of the GLOBAL LEADERS trial.
Observational study in Cardiovascular diabetology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01813435 (GLOBAL LEADERS), which is not on this map. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
GLOBAL LEADERS: A Clinical Study Comparing Two Forms of Anti-platelet Therapy After Stent Implantation
Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Abbreviated dual antiplatelet therapy in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials.BMC cardiovascular disorders · 2025Pooled it
- Ticagrelor monotherapy after a short course of dual antiplatelet therapy with ticagrelor plus aspirin following percutaneous coronary intervention in patients with versus without diabetes mellitus: a meta-analysis of randomized trials.BMC cardiovascular disorders · 2024Pooled it
- Antiplatelet agents for chronic kidney disease.The Cochrane database of systematic reviews · 2022Pooled it
- Ticagrelor versus clopidogrel inRenal failure · 2025Trial
- Ticagrelor-based antiplatelet therapy after percutaneous coronary intervention in chronic coronary syndrome.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- Comparison of 1-Year Clinical Outcomes Between Ticagrelor Versus Clopidogrel in Type 2 Diabetes Patients After Implantation of Small Diameter Stents.Anatolian journal of cardiology · 2025Article
- Prognostic value of elevated postoperative high-sensitivity troponin T in diabetes mellitus patients for ischemic events within 12 months after PCI in ACS patients: a retrospective cohort study.Frontiers in cardiovascular medicine · 2025Article
- Platelets, inflammation, and purinergic receptors in chronic kidney disease.Kidney international · 2024Review
- Management Considerations for Acute Coronary Syndromes in Chronic Kidney Disease.Current cardiology reports · 2024Review
- Updates on New Therapies for Patients with CKD.Kidney international reports · 2024Review
- Impact of chronic kidney disease and diabetes on clinical outcomes in women undergoing PCI.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Review
- P2YNature reviews. Cardiology · 2022Review
- Endothelial biomarkers and platelet reactivity on ticagrelor versus clopidogrel in patients after acute coronary syndrome with and without concomitant type 2 diabetes: a preliminary observational study.Cardiovascular diabetology · 2022Observational
- Aspirin-free antiplatelet regimens after PCI: insights from the GLOBAL LEADERS trial and beyond.European heart journal. Cardiovascular pharmacotherapy · 2021Article
- Antithrombotic therapy in diabetes: which, when, and for how long?European heart journal · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 14 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with both diabetes mellitus (DM) and chronic kidney disease (CKD) are a subpopulation characterized by ultrahigh ischemic and bleeding risk after percutaneous coronary intervention. There are limited data on the impact of ticagrelor monotherapy among these patients.
methodsIn this post hoc analysis of the GLOBAL-LEADERS trial, the treatment effects of the experimental (one-month dual-antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) versus the reference regimen (12-month DAPT followed by 12-month aspirin alone) were analyzed according to DM/CKD status. The primary endpoint was a composite endpoint of all-cause death or new Q-wave myocardial infarction at 2-years. The patient-oriented composite endpoint (POCE) was defined as the composite of all-cause death, any stroke, site-reported MI and any revascularization, whereas net adverse clinical events (NACE) combined POCE with BARC type 3 or 5 bleeding events.
resultsAt 2 years, the DM + /CKD + patients had significantly higher incidences of the primary endpoint (9.5% versus 3.1%, adjusted HR 2.16; 95% CI [1.66-2.80], p < 0.001), BARC type 3 or 5 bleeding events, stroke, site-reported myocardial infraction, all revascularization, POCE, and NACE, compared with the DM-/CKD- patients. Among the DM + /CKD + patients, after adjustment, there were no significant differences in the primary endpoints between the experimental and reference regimen; however, the experimental regimen was associated with lower rates of POCE (20.6% versus 25.9%, HR 0.74; 95% CI [0.55-0.99], p = 0.043, p
conclusionAmong patients with both DM and CKD, ticagrelor monotherapy was not associated with lower rates of all-cause death or new Q-wave, or major bleeding complications; however, it was associated with lower rates of POCE and NACE. These findings should be interpreted as hypothesis-generating. CLINICAL
trial registrationClinicalTrials.gov (NCT01813435).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.