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August 9, 2022JAMAOpen Access

Association of Dual Antiplatelet Therapy With Ticagrelor With Vein Graft Failure After Coronary Artery Bypass Graft Surgery

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Why the study?

The role of ticagrelor with or without aspirin after coronary artery bypass graft surgery remains unclear.

Does ticagrelor DAPT or ticagrelor monotherapy reduce saphenous vein graft failure compared to aspirin in patients undergoing coronary artery bypass graft surgery?

Population

1316 patients with 1668 saphenous vein grafts undergoing coronary artery bypass graft surgery

Comparison

Ticagrelor DAPT or ticagrelor monotherapy vs aspirin

Design

Individual patient data meta-analysis of 4 RCTs

Authors

SSSigrid SandnerBRBjörn RedforsDADominick J. Angiolillo

Discussion

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Overview

Ticagrelor DAPT may warrant consideration post-CABG to curb graft failure; extends low-certainty meta-analysis data while bleeding risk persists.

Structured PICO

Does ticagrelor DAPT or ticagrelor monotherapy reduce saphenous vein graft failure compared to aspirin in patients undergoing coronary artery bypass graft surgery?

P
Population
1,316 patients undergoing coronary artery bypass graft surgery (pooled from 4 RCTs involving 1,668 saphenous vein grafts). The primary analysis included 871 patients (median age 66-67 years, approximately 15% female).
I
Intervention
Ticagrelor dual antiplatelet therapy (DAPT) (ticagrelor added to aspirin) or ticagrelor monotherapy
C
Comparator
Aspirin monotherapy
O
Outcome
Incidence of saphenous vein graft failure per grafthard clinical

Adding ticagrelor to aspirin after coronary artery bypass graft surgery significantly reduces the risk of vein graft failure but increases the risk of clinically important bleeding, whereas ticagrelor monotherapy shows no significant difference compared to aspirin.

Cite This Study

Sandner et al. (2022) studied this question.

synapsesocial.com/papers/69fd7e37eaf018ad124ba084https://doi.org/10.1001/jama.2022.11966
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