Key result
Dual antiplatelet therapy before urgent coronary artery bypass grafting was associated with a higher rate of major bleeding compared to ASA monotherapy (44% vs. 23%, p < 0.0001).
Why the study?
In patients with acute coronary syndrome treated with dual antiplatelet therapy, urgent coronary artery bypass grafting might be associated with an increased risk of bleeding complications.
Does dual antiplatelet therapy increase major bleeding in patients undergoing urgent coronary artery bypass grafting compared to ASA monotherapy?
Cohort (n=1,086)
No
Does dual antiplatelet therapy increase major bleeding in patients undergoing urgent coronary artery bypass grafting compared to ASA monotherapy?
Absolute Event Rate: 44% vs 23%
p-value: p=< 0.0001
In patients requiring urgent CABG, preoperative dual antiplatelet therapy significantly increases the risk of major bleeding compared to aspirin monotherapy.
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Preoperative DAPT was associated with higher major bleeding in urgent CABG; leaves open optimal strategy pending randomized trials.
Deppe et al. (2020) conducted a cohort in Acute coronary syndrome requiring urgent coronary artery bypass grafting (n=1,086). Dual antiplatelet therapy vs. ASA monotherapy was evaluated on Major bleeding (transfusion ≥ 5 packed red blood cells within 24 hours, rethoracotomy due to bleeding, or chest tube output >2000 mL within 24 hours) (p=< 0.0001). Dual antiplatelet therapy before urgent coronary artery bypass grafting was associated with a higher rate of major bleeding compared to ASA monotherapy (44% vs. 23%, p < 0.0001).
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