DAPT with ticagrelor and aspirin combo reduces saphenous vein graft failure in CABG: JAMA

Results:

• A total of 4 RCTs were included in the meta-analysis, involving 1316 patients and 1668 saphenous vein grafts.
• Of the 871 patients in the primary analysis, 435 received ticagrelor DAPT and 436 received aspirin.
• There were 65 women and 370 men among the 435 patients who received ticagrelor DAPT with a median age of 67 years. 
• There were 63 women and 373 men among the 436 patients who received aspirin with median age, of 66 years.
• Ticagrelor DAPT was associated with a significantly lower incidence of saphenous vein graft failure (11.2%) per graft than was aspirin and was associated with a significantly lower incidence of saphenous vein graft failure per patient.
• Ticagrelor DAPT (22.1%) was associated with a significantly higher incidence of BARC type 2, 3, or 5 bleeding events than was aspirin, but not BARC type 3 or 5 bleeding events.
• Compared with aspirin, ticagrelor monotherapy was not significantly associated with saphenous vein graft failure or BARC type 2, 3, or 5 bleeding events. 

Thus, the researchers concluded that ticagrelor with aspirin was associated with a significantly decreased risk of vein graft failure among patients undergoing coronary artery bypass graft surgery. They also suggested that this was associated with a significantly increased risk of clinically important bleeding. 

For the full article, click here: 10.1001/jama.2022.11966 

Sandner S, Redfors B, Angiolillo DJ, et al. Association of Dual Antiplatelet Therapy With Ticagrelor With Vein Graft Failure After Coronary Artery Bypass Graft Surgery: A Systematic Review and Meta-analysis. JAMA. 2022;328(6):554-562.