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Effect of Ticagrelor Plus Aspirin, Ticagrelor Alone, or Aspirin Alone on Saphenous Vein Graft Patency 1 Year After Coronary Artery Bypass Grafting: A Randomized Clinical Trial

Tuesday, April 24, 2018

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Qiang Zhao, Yunpeng Zhu, Zhiyun Xu, Zhaoyun Cheng, Ju Mei, Xin Chen, Xiaowei Wang

The authors report on a randomized, multicenter, open-label, clinical trial involving 500 patients with 1460 saphenous vein grafts (SVG) who were assigned to three groups: (1) ticagrelor + asprin (ASA), (2) ticagrelor alone, or (3) ASA alone.  Neither patients nor physicians were blinded to the allocation.  The primary outcome was SVG patency at one year, assessed by either coronary angiography or CT angiography.

Results: The SVG patency rates for groups 1,2, and 3 were 88.7%, 82.8%, and 76.5%.  The differences between group 1 and group 3 were significant at p<0.001.  The differences between the remaining groups were not significant.

Conclusion: Among patients undergoing elective coronary artery bypass grafting, the combination of ASA and ticagrelor resulted in higher SVG patency at one year over ASA alone.  Five major bleeding episdoes occurred during one year of follow-up, all in either group 1 or 2.

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