open access

Vol 29, No 1 (2022)
Study Protocol
Submitted: 2021-06-20
Accepted: 2021-08-11
Published online: 2021-09-30
Get Citation

Low-dose ticagrelor with or without acetylsalicylic acid in patients with acute coronary syndrome: Rationale and design of the ELECTRA-SIRIO 2 trial

Jacek Kubica1, Piotr Adamski1, Diana A. Gorog23, Aldona Kubica1, Bernd Jilma4, Andrzej Budaj5, Jolanta M. Siller-Matula46, Paul A. Gurbel7, Dimitrios Alexopoulos8, Jolita Badarienė910, Paweł Dąbrowski11, Dariusz Dudek1213, Evangelos Giannitsis14, Grzegorz Horszczaruk15, Miłosz J. Jaguszewski16, Stefan James17, Young-Hoon Jeong18, Michał Kryjak19, Piotr Niezgoda1, Małgorzata Ostrowska1, Giuseppe Patti20, Janusz Romanek21, Salvatore Di Somma22, Giuseppe Specchia23, Udaya Tantry7, Mariusz Gąsior24, Agnieszka Tycińska25, Wojciech Wojakowski26, Katarzyna Buszko1, Robert Gil27, Marcin Gruchała16, Jarosław Kasprzak28, Andrzej Kleinrok1129, Jacek Legutko30, Maciej Lesiak31, Eliano P. Navarese1
Pubmed: 34622433
Cardiol J 2022;29(1):148-153.
  1. Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
  2. Postgraduate Medical School, University of Hertfordshire, Stevenage, United Kingdom
  3. Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom
  4. Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland, Austria
  5. Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
  6. Department of Cardiology, Medical University of Vienna, Austria
  7. Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital, Life Bridge Health System, Baltimore, MD, United States
  8. National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece
  9. Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
  10. Center of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
  11. Department of Cardiology, The Pope John Paul II Hospital, Zamosc, Poland
  12. Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
  13. Maria Cecilia Hospital, GVM Care and Research, Cotignola (RA), Ravenna, Italy
  14. Medizinische Klinik III, Department of Cardiology, Angiology and Pulmology, University Hospital of Heidelberg, Germany
  15. Department of Cardiology, Voivodeship Hospital, Lomza, Poland
  16. 1st Department of Cardiology, Medical University of Gdansk, Poland
  17. Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala, Sweden
  18. Department of Internal Medicine, Gyeongsang National University School of Medicine and Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, South Korea
  19. Department of Cardiology, The Doctor Sokolowski Hospital, Walbrzych, Poland
  20. University of Eastern Piemont, Maggiore della Carità Hospital, Novara, Italy
  21. Cardiology Department with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No. 2, Faculty of Medicine, University of Rzeszow, Poland
  22. Department of Medical-Surgery Sciences and Translational Medicine, University La Sapienza, Rome, Italy
  23. Pavia, Italy
  24. 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze, Poland
  25. Department of Cardiology, Medical University of Bialystok, Poland
  26. Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
  27. Department of Invasive Cardiology, Center of Postgraduate Medical Education, Central Hospital of the Internal Affairs and Administration Ministry, Warsaw, Poland
  28. 1st Department and Chair of Cardiology, Medical University of Lodz, Bieganski Hospital, Lodz, Poland
  29. University of Information Technology and Management in Rzeszow, Poland
  30. Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College and John Paul II Hospital in Krakow, Poland
  31. Chair and 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland

open access

Vol 29, No 1 (2022)
Study protocol — Clinical cardiology
Submitted: 2021-06-20
Accepted: 2021-08-11
Published online: 2021-09-30


Not available


Not available
Get Citation
Supp./Additional Files (1)
Supplementary Appendix
About this article

Low-dose ticagrelor with or without acetylsalicylic acid in patients with acute coronary syndrome: Rationale and design of the ELECTRA-SIRIO 2 trial


Cardiology Journal


Vol 29, No 1 (2022)

Article type

Study Protocol



Published online


Page views


Article views/downloads






Bibliographic record

Cardiol J 2022;29(1):148-153.


Jacek Kubica
Piotr Adamski
Diana A. Gorog
Aldona Kubica
Bernd Jilma
Andrzej Budaj
Jolanta M. Siller-Matula
Paul A. Gurbel
Dimitrios Alexopoulos
Jolita Badarienė
Paweł Dąbrowski
Dariusz Dudek
Evangelos Giannitsis
Grzegorz Horszczaruk
Miłosz J. Jaguszewski
Stefan James
Young-Hoon Jeong
Michał Kryjak
Piotr Niezgoda
Małgorzata Ostrowska
Giuseppe Patti
Janusz Romanek
Salvatore Di Somma
Giuseppe Specchia
Udaya Tantry
Mariusz Gąsior
Agnieszka Tycińska
Wojciech Wojakowski
Katarzyna Buszko
Robert Gil
Marcin Gruchała
Jarosław Kasprzak
Andrzej Kleinrok
Jacek Legutko
Maciej Lesiak
Eliano P. Navarese

References (14)
  1. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019; 40(2): 87–165.
  2. Wallentin L, Becker R, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009; 361(11): 1045–1057.
  3. Storey RF, Angiolillo DJ, Bonaca MP, et al. Platelet inhibition with ticagrelor 60 mg versus 90 mg twice daily in the PEGASUS-TIMI 54 trial. J Am Coll Cardiol. 2016; 67(10): 1145–1154.
  4. Kubica J, Adamski P, Ostrowska M, et al. Morphine delays and attenuates ticagrelor exposure and action in patients with myocardial infarction: the randomized, double-blind, placebo-controlled IMPRESSION trial. Eur Heart J. 2015; 37(3): 245–252.
  5. Bonaca MP, Bhatt DL, Cohen M, et al. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med. 2015; 372(19): 1791–1800.
  6. Kubica J, Adamski P, Buszko K, et al. Platelet inhibition with standard vs. lower maintenance dose of ticagrelor early after myocardial infarction (ELECTRA): a randomized, open-label, active-controlled pharmacodynamic and pharmacokinetic study. Eur Heart J Cardiovasc Pharmacother. 2019; 5(3): 139–148.
  7. Mehran R, Baber U, Sharma S, et al. Ticagrelor with or without Aspirin in High-Risk Patients after PCI. N Engl J Med. 2019; 381(21): 2032–2042.
  8. Kubica J, Adamski P, Niezgoda P, et al. A new approach to ticagrelor-based de-escalation of antiplatelet therapy after acute coronary syndrome. A rationale for a randomized, double-blind, placebo-controlled, investigator-initiated, multicenter clinical study. Cardiol J. 2021; 28(4): 607–614.
  9. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction . Eur Heart J. 2019; 40(3): 237–269.
  10. Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021; 42(14): 1289–1367.
  11. Zaman A, de Winter RJ, Kogame N, et al. Safety and efficacy of a sirolimus-eluting coronary stent with ultra-thin strut for treatment of atherosclerotic lesions (TALENT): a prospective multicentre randomised controlled trial. Lancet. 2019; 393(10175): 987–997.
  12. Sibbing D, Aradi D, Jacobshagen C, et al. Guided de-escalation of antiplatelet treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention (TROPICAL-ACS): a randomised, open-label, multicentre trial. Lancet. 2017; 390(10104): 1747–1757.
  13. Cuisset T, Deharo P, Quilici J, et al. Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study. Eur Heart J. 2017; 38(41): 3070–3078.
  14. De Luca L, D'Ascenzo F, Musumeci G, et al. Incidence and outcome of switching of oral platelet P2Y12 receptor inhibitors in patients with acute coronary syndromes undergoing percutaneous coronary intervention: the SCOPE registry. EuroIntervention. 2017; 13(4): 459–466.


Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: