Ticagrelor + Aspirin Beneficial After Elective CABG

Increased saphenous vein graft patency rates compared with aspirin alone one year post-CABG
Increased saphenous vein graft patency rates compared with aspirin alone one year post-CABG

HealthDay News — For patients undergoing elective coronary artery bypass grafting (CABG), ticagrelor + aspirin is associated with significantly increased saphenous vein graft patency rates compared with aspirin alone, according to a study published in the April 24 issue of the Journal of the American Medical Association.

Qiang Zhao, MD, PhD, from the Ruijin Hospital Shanghai Jiao Tong University School of Medicine, and colleagues randomized eligible patients aged 18 to 80 years with indications for elective CABG to start ticagrelor + aspirin (168 patients), ticagrelor alone (166 patients), or aspirin alone (166 patients) within 24 hours post-CABG; 92.2% of patients completed the trial. 

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The researchers found that the rates of saphenous vein graft patency were 88.7, 82.8, and 76.5%, respectively, with ticagrelor + aspirin, ticagrelor alone, and aspirin alone at one year post-CABG. There was a statistically significant difference between ticagrelor + aspirin versus aspirin alone (12.2%; 95% CI, 5.2 to 19.2%; P<.001); for ticagrelor alone and aspirin alone, the difference was not statistically significant (6.3%; 95% CI, −1.1 to 13.7%; P=.1). During 1 year of follow-up, there were 5 major bleeding episodes (3 and 2 with ticagrelor + aspirin and ticagrelor alone, respectively).

"Further research with more patients is needed to assess comparative bleeding risks," the authors write.

Several authors disclosed financial ties to the medical device and pharmaceutical industries; the study was funded by AstraZeneca, the manufacturer of ticagrelor.

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