Dual antiplatelet therapy after CABG linked to a key benefit—and a key risk

Jessica Kania | August 29, 2022 | Cardiovascular Business | Cardiac Surgery

After coronary artery bypass graft (CABG) surgery, a regimen of ticagrelor plus aspirin significantly reduced patients’ risk of vein graft failure compared to aspirin alone, according to a new meta-analysis published in JAMA.[1] However, the combined ‘dual therapy’ also increased the risk of a potentially dangerous bleeding event.

Approximately 11% of CABG patients who took both ticagrelor and aspirin experienced vein graft failure, compared with 20% of patients who took aspirin alone, according to the review. Yet 22.1% of the dual therapy patients experienced significant bleeding events (categorized as types 2, 3, or 5 according to the Bleeding Academic Research Consortium scale), compared to just 8.7% of the aspirin-only patients.

“We found that, yes, this dual therapy significantly reduces the risk that the grafts will fail. However, for the first time, we have shown that this approach also carries a significant risk of clinically important bleeding,” Gaudino, a professor of cardiothoracic surgery at Weill Cornell Medicine and a cardiothoracic surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, said in a statement about the review. “So, the benefit comes at a price.”

The four smaller-scale studies included in the team's meta-analysis had originally reached conflicting conclusions. By compiling, combining, and analyzing the raw data from all four studies as part of their review, the authors offer a more comprehensive and decisive answer for patients and physicians seeking guidance.

Robotic IVC thrombectomy: A safe, effective alternative to open surgery

Cardiologists make history, becoming first to use FDA-cleared retrieval device to remove a heart tumor

Surgeons behind historic pig heart transplant to share their story at HFSA annual meeting

Cardiac surgeons gaining procedural volume despite TAVR making up 84% of cases

Jessica Kania

Jessica Kania is a digital editor who has worked across the Innovate Healthcare brands, including Radiology Business, Health Imaging, AI in Healthcare and Cardiovascular Business. She also has vast experience working on custom content projects focused on technology innovation, clinical excellence, operational efficiency and improving financial performance in healthcare.

Around the web

Health Exec

Major association of physicians presents itself as a go-to alternative vs. the government on vaccine expertise

One of the most formidable societies of medical professionals in the U.S. is going toe-to-toe with Robert F. Kennedy’s HHS over changing vaccination recommendations.

Health Exec

Tom Price: Medical residency slots need to expand to combat physician shortages

Tom Price, MD, former secretary of Health and Human Services (HHS), said one way to address the growing shortage of physicians is to expand medical resident positions, but these are tied to Medicare spending so alternative means may be needed.

Health Imaging

Tariffs will have a significant impact on the nuclear imaging supply chain in the US

"Domestic radiopharmaceutical suppliers, who receive isotopes from abroad, would be impacted by price changes and uncertainty caused by additional tariffs,” SNMMI President Cathy Cutler, PhD, wrote in a letter to the U.S. Department of Commerce this week.