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Bleeding in Patients Treated With Ticagrelor or Clopidogrel Before Coronary Artery Bypass Grafting
Holm and colleagues evaluated perioperative bleeding after coronary artery bypass grafting (CABG) in patients who were taking P2Y12 inhibitors. Patient outcomes from the European Multicenter Registry on Coronary Artery Bypass Grafting were included in the analysis, with 1,293 patients who received clopidogrel preoperatively and 1,018 who received ticagrelor. The authors observed a higher incidence of major bleeding in patients when these therapies were discontinued for fewer days prior to CABG, and they suggest postponing nonemergent procedures for at least 3 and 4 days after discontinuation of ticagrelor and clopidogrel, respectively.