Dual Antiplatelet Therapy After Heart Bypass Surgery Offers No Added Benefit Over Aspirin Alone

The lead interrogator is Anders Jeppsson, professor successful cardiothoracic room astatine nan University of Gothenburg and elder advisor astatine Sahlgrenska University Hospital, arsenic good arsenic initiator and chair of nan steering committee of nan TACSI trial.

Risk simplification unclear until now

The TACSI study compares 2 different antiplatelet (blood thinning) therapies aft bosom bypass room for acute coronary bosom disease. On nan 1 manus azygous antiplatelet therapy pinch acetylsalicylic acerb (Aspirin) alone, and connected nan different manus dual antiplatelet therapy pinch aspirin and ticagrelor (Brilique). Dual antiplatelet therapy is presently recommended for these patients successful world guidelines.

It is unequivocal that this diligent group needs antiplatelet therapy. However, until now it has been unclear whether dual therapy aft room further reduces nan risks of decease and cardiovascular complications aft nan operation.

The 2,201 patients included successful nan study were randomly assigned to person either ticagrelor and aspirin (1,104 patients) aliases aspirin unsocial (1,097 patients). The mean property of nan participants was 66 years and nan proportionality of women was 14.4 percent. The follow-up play was 12 months aft surgery.

The results show nary quality betwixt nan groups wrong nan study's superior focus: a composite measurement of nan risks of dying, having a bosom onslaught aliases stroke, aliases needing different coronary intervention. The proportionality affected wrong 1 twelvemonth was conscionable nether 5 percent for some groups.

No support for dual therapy

However, nan researchers recovered that nan groups did disagree if excessive bleeding was besides included. When including excessive bleeding, nan proportionality affected was 9.1 percent successful nan group receiving some ticagrelor and aspirin and 6.4 percent successful nan group receiving aspirin alone. Excessive bleeding was seen successful 4.9 percent of patients connected dual therapy, arsenic compared to 2.0 percent successful nan different diligent group.

Anders Jeppsson notes that while nan patients request to beryllium followed up for much than 1 year, we tin still tie immoderate conclusions:

"Our 12-month information do not support nan usage of dual therapy complete aspirin unsocial successful patients pinch acute coronary syndrome who person undergone bosom bypass surgery. We did not observe immoderate betterment successful superior cardiovascular events, but a higher consequence of excessive bleeding successful nan dual antiplatelet therapy group," he says.