RecruitingPhase 3NCT07257198

Aspirin-free Strategy With Ticagrelor in Patients With a Myocardial Infarction Treated Medically Alone

Evaluation of an asPirin-free Strategy With ticAgrelor in patieNTs witH a Myocardial Infarction treatEd Medically alONe (PANTHEON)


Sponsor

Montreal Heart Institute

Enrollment

2,570 participants

Start Date

Mar 3, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

In patients with a myocardial infarction (MI) treated medically alone, the objective of the PANTHEON trial is to evaluate if ticagrelor monotherapy reduces bleeding events, without an increase in patient-oriented ischemic events, compared with standard dual antiplatelet therapy (DAPT) with aspirin and ticagrelor for 12 months.


Eligibility

Min Age: 18 Years

Inclusion Criteria6

  • Age ≥18 years;
  • Hospitalized for type 1 MI, according to the 4th Universal Definition of MI;
  • Coronary angiogram performed;
  • Planned for medical management alone, without revascularization;
  • Willingness to participate and to attend study visits;
  • Expected life expectancy ≥12 months.

Exclusion Criteria10

  • Patients hospitalized for type 2-5 MI, or unstable angina, according to the 4th Universal Definition of MI;
  • Patients hospitalized for a STEMI with an acute thrombotic lesion of a major epicardial vessel;
  • Elevations in cardiac biomarkers (troponins or CK-MB) that is believed by the investigator not to be of ischemic origin (e.g. myocardial injury, myocarditis, Takotsubo syndrome, etc.);
  • Confirmed or suspected spontaneous coronary artery dissection;
  • Concomitant indication for chronic oral anticoagulant;
  • Concomitant non-coronary indication for dual antiplatelet therapy;
  • Use of any non-trial antiplatelet drug that needs to be continued based on the judgement of the treating physician;
  • Previous hospitalization for MI, PCI, or CABG within 12 months;
  • Known hypersensitivity, intolerance, or contra-indication to ASA or ticagrelor;
  • Unsuitability for either randomization treatment, based on the judgement of the treating physician

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Interventions

DRUGTicagrelor + placebo

Ticagrelor 90 mg twice daily + placebo once daily

DRUGTicagrelor + aspirin

Ticagrelor 90 mg twice daily + aspirin 80 mg once daily


Locations(1)

Montreal Heart Institute

Montreal, Quebec, Canada

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NCT07257198


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