Anaemia and a history of spontaneous gastrointestinal bleeds requiring hospitalisation are independent risk factors for bleeds in patients taking ticagrelor plus aspirin post-MI, researchers have found.

A post-hoc analysis of the PEGASUS-TIMI 54 trial has shown patients with these risk factors have three times the risk of bleeds on the dual antiplatelet regimen compared with those without the risk factors, the US investigators say.

And, importantly, the patients without the risk factors appear to derive a greater benefit from the dual therapy, having fewer ischaemic events and lower mortality, they wrote in the Journal of the American Heart Association.

Patients with one or both risk factors, however, do not appear to benefit from adding ticagrelor to aspirin, the investigators say.