Antiplatelet therapy after coronary artery bypass surgery: five year follow-up of randomised DACAB trial

Antiplatelet Therapy After Coronary Artery Bypass Surgery: Five-Year Follow-Up

Objective

To evaluate the impact of different antiplatelet strategies on patient outcomes following coronary artery bypass grafting.

Design

Five-year follow-up of the randomized DACAB trial (Different Antiplatelet Therapy Strategy After Coronary Artery Bypass Grafting).

Participants

500 patients aged 18-80 years who underwent elective coronary artery bypass grafting surgery and completed the DACAB trial.

Interventions

Patients were randomly assigned to receive either dual antiplatelet therapy, ticagrelor monotherapy, or aspirin monotherapy for one year post-surgery, with subsequent therapy based on standard care.

Main Outcome Measures

The primary outcome was the occurrence of major adverse cardiovascular events, including all-cause death, myocardial infarction, stroke, and coronary revascularization, analyzed using the intention-to-treat principle.

Results

At the five-year follow-up, dual antiplatelet therapy showed a significantly lower risk of major adverse cardiovascular events compared to aspirin monotherapy and ticagrelor monotherapy.

Conclusions

Using ticagrelor dual antiplatelet therapy for one year after surgery reduced the risk of major adverse cardiovascular events at five years following coronary artery bypass grafting when compared with aspirin monotherapy or ticagrelor monotherapy.

Trial Registration

NCT03987373 ClinicalTrials.gov NCT03987373.

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