DACAB: Ticagrelor and Aspirin Improve Vein Graft Patency

According to this Chinese study, dual antiplatelet therapy with ticagrelor and aspirin improves vein graft patency a year after surgery without increasing the risk for major bleeding.

Treatment with the P2Y12 inhibitor ticagrelor in combination with aspirin has been widely accepted for patients with acute coronary syndrome undergoing angioplasty. However, there were no related data regarding surgical revascularization.

Read also: “Ticagrelor Versus Clopidogrel in Symptomatic Peripheral Vascular Disease”.

This new information is of great interest, since 25% of all vein grafts are occluded after a year and about half of them are occluded after 10 years.

The DACAB study, presented at the American Heart Association (AHA) 2017 Scientific Sessions, enrolled 500 patients who underwent myocardial revascularization surgery and treatment with ticagrelor, aspirin, or both. All patients were started on their therapy within 24 hours after the surgery.

Vein graft patency at one year was superior in patients in the dual antiplatelet therapy group compared with those receiving aspirin alone (88.7% vs. 76.5%; p = 0.006).

Read also: “The End of Aspirin for Anticoagulated Patients Undergoing PCI”.

The rate of combined events was highest in the aspirin monotherapy arm (5.4%) compared with the ticagrelor alone arm (2.4%), and the combination therapy group (1.8%).

Due to certain study design limitations, many experts said that these results are interesting but preliminary.

Original title: Efficacy and Safety of a Dual Ticagrelor Plus Aspirin Antiplatelet Strategy After Coronary Artery Bypass Grafting: The DACAB Randomized Clinical Trial.

Reference: Zhao Q. American Heart Association 2017 Scientific Sessions. 12 de noviembre del 2017.

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