Clopidogrel versus Ticagrelor for Secondary Prevention after Coronary Artery Bypass Grafting
Key result
Aspirin plus ticagrelor did not significantly change the risk of MACCE and major bleeding compared to aspirin plus clopidogrel after total arterial OPCAB (HR 1.0; 95% CI 0.4-2.3; P=0.972).
Why the study?
The study sought to evaluate the outcomes of postoperative three-month dual antiplatelet therapy in patients with NSTE-ACS following OPCAB with exclusively arterial grafts.
Does aspirin + ticagrelor improve overall survival and reduce MACCE and major bleeding compared to aspirin + clopidogrel in patients with NSTE-ACS following OPCAB?
Population
269 NSTE-ACS patients after total arterial OPCAB
Comparison
Aspirin plus clopidogrel vs aspirin plus ticagrelor
Design
Propensity score-matched cohort study
Follow-up
One year
Authors
Discussion
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Member takes
Implication
Supports observational equipoise between agents; leaves open optimal DAPT after total arterial OPCAB in NSTE-ACS.
Study Design
Type
Cohort (n=269)
Structured PICO
Does aspirin + ticagrelor improve overall survival and reduce MACCE and major bleeding compared to aspirin + clopidogrel in patients with NSTE-ACS following OPCAB?
P
Population
269 patients with NSTE-ACS following total arterial off-pump coronary artery bypass grafting, treated with 3-month dual antiplatelet therapy.
E
Exposure
Aspirin + ticagrelor for three months postoperatively
C
Comparator
Aspirin + clopidogrel for three months postoperatively
O
Outcome
Overall survival and composite outcome of major adverse cerebrovascular and cardiovascular event (MACCE) and major bleedingcomposite
Main Result
Hazard Ratio: 1 (95% CI 0.4–2.3)
p-value: p=0.972
Three-month dual antiplatelet therapy with aspirin and ticagrelor showed similar outcomes to aspirin and clopidogrel regarding survival, MACCE, and major bleeding in NSTE-ACS patients after total arterial OPCAB.
Cite This Study
Chang et al. (2019) conducted a cohort in Non-ST-elevation acute coronary syndrome (NSTE-ACS) following off-pump coronary artery bypass grafting (OPCAB) (n=269). Aspirin + Ticagrelor vs. Aspirin + Clopidogrel was evaluated on Composite outcome of major adverse cerebrovascular and cardiovascular event (MACCE) and major bleeding (HR 1.0, 95% CI 0.4-2.3, p=0.972). Aspirin plus ticagrelor did not significantly change the risk of MACCE and major bleeding compared to aspirin plus clopidogrel after total arterial OPCAB (HR 1.0; 95% CI 0.4-2.3; P=0.972).