[Antiplatelet therapy before coronary artery bypass surgery. Is the bridging therapy possible?]

The number of patients with coronary artery disease undergoing percutaneous coronary interventions (PCI) with stenting is growing. Stenting is associated with dual antiplatelet given until endothelization of stent. In some clinical situations surgery is required, e.g. coronary bypass, before stent is endothelized or soon after acute coronary syndrome, while even short-time antiplatelet therapy cessation might result in fatal sequelae. Nevertheless, before major surgeries, including coronary artery bypass surgery, antiplatelets (particulary thyenopyridines and ticagrelor) sometimes need to be stopped and bridging therapy with short-acting antithrombotics started. The article reviews data on bridging therapy before coronary bypass surgery.