ClinicalTrials.gg
RecruitingNCT07257198PANTHEONUpdated Mar 10, 2026

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

A Phase 3 interventional study of Ticagrelor + placebo and Ticagrelor + aspirin in NSTEMI - Non-ST Segment Elevation MI, STEMI (ST Elevation MI) and Myocardial Infarction, sponsored by Montreal Heart Institute. Recruiting at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-10.

Sponsored by Montreal Heart Institute · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2026; still recruiting 8 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
2,570
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 18 studies in Non-ST Elevated Myocardial Infarction with a site in Canada — 3 open to participants now, 5 under way, 2 of them phase 3. Non-ST Elevated Myocardial Infarction · Canada.

Planned enrollment
8th of 16
2,570 · median 1,911
Started
2026
the only one that year
Phase 3
7 of 18
2 open now
Registered
18th of 18
by date
Lead sponsor
1 of 18
Montreal Heart Institute

Among the 18 studies in Non-ST Elevated Myocardial Infarction with a site in Canada, this one is the 8th largest by planned enrollment of the 16 interventional ones that give a count, is the only one that started in 2026, is one of 7 in phase 3, and was the 18th registered.

Non-ST Elevated Myocardial Infarction

284 studies on the registry are indexed under Non-ST Elevated Myocardial Infarction; 52 are open to participants now.

Browse Non-ST Elevated Myocardial Infarction studies →

Open to participants now

3 of the 18 studies in Non-ST Elevated Myocardial Infarction with a site in Canada are open now. Recruiting first, the newest first:

All 3 open studies →

A study can be open while its sites in Canada have not opened yet or have stopped. Only those recruiting at a site in Canada →

Who these studies take

Of the 40 Non-ST Elevated Myocardial Infarction studies recruiting now, 34 (85%) set no upper age limit and 1 (3%) stops at 75 or younger; 4 take children under 18; 2 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 18 studies in Non-ST Elevated Myocardial Infarction with a site in Canada, or all of them as a file.
02

Study 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.

Read the detailed description

Coronary artery disease is associated with more than 9 million deaths per year worldwide. Following hospital discharge for an MI, both bleeding and recurrent ischemic events are associated with a high risk of subsequent mortality. However, the optimal antiplatelet strategy balancing bleeding and ischemic risks in the vulnerable population of patients with a medically managed MI patients (without revascularization) remains unknown, leading to substantial variability in clinical practice. This group represents 35-45% of patients wit hMI in Canada and the United States.

Primary Objectives To evaluate whether ticagrelor monotherapy is superior to dual antiplatelet therapy (DAPT) in reducing the risk of type 2, 3, or 5 bleeding events according to the BARC classification at 12 months.

To evaluate whether ticagrelor monotherapy is non-inferior to dual antiplatelet therapy (DAPT) for the composite endpoint of all-cause mortality, myocardial infarction, stroke, or coronary revascularization - a standardized, patient-centered ischemic clinical endpoint as defined by the Academic Research Consortium - at 12 months.

Secondary Objectives To evaluate differences between ticagrelor monotherapy and DAPT regarding the following endpoints at 12 months: individual components of the two primary endpoints; BARC type 3 or 5 bleeding; TIMI minor or major bleeding and its individual components; cardiovascular mortality; any coronary revascularization; the composite of all-cause mortality, MI, or stroke; and NACE, a composite of all-cause mortality, MI, stroke, any coronary revascularization, or type 2, 3, or 5 BARC bleeding.

03

Conditions studied

  • NSTEMI - Non-ST Segment Elevation MI
  • STEMI (ST Elevation MI)
  • Myocardial Infarction

Keywords

  • Dual antiplatelet therapy
  • NSTEMI
  • medical treatment
  • STEMI
  • aspirin
  • ticagrelor
  • bleeding
  • ischemic events
  • randomized trial
  • pragmatic trial
  • randomized controlled trial
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 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 ≥12 months.

Exclusion criteria

Exclusion criteria:

  • 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 , intolerance, or to ASA or ticagrelor;
  • Unsuitability for either randomization treatment, based on the judgement of the treating physician
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
2,570 participants (estimated)

Study arms

  • Experimental
    Ticagrelor monotherapy

    Ticagrelor 90 mg orally twice daily + placebo orally once daily

    Drug: Ticagrelor + placebo

  • Active comparator
    DAPT with ticagrelor and aspirin

    Ticagrelor 90 mg orally twice daily + aspirin 80 mg orally once daily

    Drug: Ticagrelor + aspirin

Interventions

  • DrugTicagrelor + placebo

    Ticagrelor 90 mg twice daily + placebo once daily

  • DrugTicagrelor + aspirin

    Drug pages: Ticagrelor · Aspirin

    Ticagrelor 90 mg twice daily + aspirin 80 mg once daily

06

What researchers measure

Primary outcomes

  1. Bleeding

    Time to first BARC type 2, 3, or 5 bleeding

    Time frame: From randomization to 12 months

  2. Patient-oriented ischemic clinical endpoint

    Time to first composite of all-cause mortality, MI, stroke, or any coronary revascularization

    Time frame: From randomization to 12 months

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Mar 2026 (actual). Primary completion is estimated for Jan 2030, 45 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 20, 2025
First posted
Dec 2, 2025
StartActual
Mar 3, 2026
Primary completionEst.
Jan 1, 2030
CompletionEst.
Jan 1, 2031
Last update
Mar 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07257198
Responsible party
Guillaume Marquis-Gravel (Associate professor of clinic, Université de Montréal) — Principal investigator
First posted
Dec 2, 2025
Start date
Mar 3, 2026
Primary completion
Jan 1, 2030 (estimated)
Completion
Jan 1, 2031 (estimated)
Last update
Mar 10, 2026

Study contacts

Guillaume Marquis-Gravel, MD
Contact
guillaume.marquis.gravel@umontreal.ca
1-514-376-3330 ext. 2777
Roseline Therrien
Contact
roseline.therrien@seriant.org
1-514-461-1300 ext. 2007

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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