Ticagrelor and aspirin for the prevention of cardiovascular events after coronary artery bypass graft surgery

Heart
Jacqueline SawJohn Cairns

Abstract

Ticagrelor was shown to reduce mortality in patients who underwent coronary artery bypass grafting (CABG), but its effect on graft patency is unknown. We performed a prospective, randomised, double-blind, placebo-controlled trial, comparing ticagrelor 90 mg twice daily versus placebo for 3 months added to aspirin 81 mg/day, following isolated CABG. Aspirin was started within 12 h, and study medication within 72 h after CABG. Primary outcome was graft occlusion on CT angiography (CTA) performed 3 months post CABG. Patients were followed to 12 months for death, myocardial infarction, stroke, repeat revascularisation and bleeding. The study was terminated prematurely after randomising 70 patients between September 2011 and August 2014 because of slow recruitment. CTA was performed in 56 patients who completed >1 month of study drug. Graft occlusion occurred in 7/25 (28.0%) patients on ticagrelor and 17/31 (48.3%) on placebo, p=0.044. Of 207 analysable grafts, graft occlusion occurred in 9/87 (10.3%) with ticagrelor and 22/120 (18.3%) with placebo, p=0.112. Graft occlusion or stenosis ≥50% occurred in 10/87 (11.5%) ticagrelor vs 32/120 (26.7%) placebo, p=0.007. There was no major bleeding, but minor bleeding was higher with ticagre...Continue Reading

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Citations

Dec 14, 2017·Interactive Cardiovascular and Thoracic Surgery·Yejing ZhaoJinghua Liu
Dec 16, 2017·Current Medical Research and Opinion·Christopher J HammettUNKNOWN PERMIT Program Consensus Group
Jun 21, 2017·Anesthesia and Analgesia·Jörn A KarhausenMiklos D Kertai
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Aug 11, 2020·Interactive Cardiovascular and Thoracic Surgery·Saurabh GuptaRichard P Whitlock
Jan 29, 2021·Journal of Cardiac Surgery·Nimryta SembiAmer Harky
Mar 25, 2021·Journal of Cardiovascular Pharmacology·Trevor SimardBenjamin Hibbert
Mar 17, 2020·Circulation Journal : Official Journal of the Japanese Circulation Society·Masato NakamuraAtsushi Hirayama
Dec 7, 2018·The Journal of Thoracic and Cardiovascular Surgery·Antonio M Calafiore, Michele Di Mauro

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