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Ticagrelor for patients undergoing coronary artery bypass grafting: A meta-analysis of randomized controlled trials

Feng Xiang1, Yifeng Lin1, Binwu Chen1

  • 1Department of Pharmacy, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Perfusion
|April 11, 2022
PubMed

Insights

Ticagrelor therapy significantly reduces the risk of saphenous vein graft occlusion one year after coronary artery bypass grafting (CABG). This finding offers an alternative to aspirin for patients undergoing CABG surgery.

Area of Science:

  • Cardiology
  • Pharmacology
  • Surgical Outcomes

Background:

  • Ticagrelor offers potent platelet inhibition, potentially serving as an alternative to aspirin.
  • The efficacy of ticagrelor in patients undergoing coronary artery bypass grafting (CABG) requires further confirmation.

Approach:

  • A meta-analysis of randomized controlled trials was conducted to evaluate ticagrelor's impact on CABG patient outcomes.
  • Searched major databases (PubMed, Embase, EBSCO, Cochrane) up to December 2020 for relevant studies.
  • Primary outcome: saphenous vein graft (SVG) occlusion at 1 year; Secondary outcomes: SVG occlusion at 7 days, major adverse cardiovascular events (MACE), and bleeding requiring reoperation.

Key Points:

  • Seven trials involving 4305 patients were analyzed.
  • Ticagrelor therapy resulted in a significantly lower risk of SVG occlusion at 1 year (11.4% vs. 14.3%, RR 0.79, p=0.03).
  • No significant differences were observed in SVG occlusion at 7 days, MACE, or bleeding requiring reoperation.

Conclusions:

  • Ticagrelor therapy is associated with a reduced risk of saphenous vein graft occlusion one year post-CABG.
  • The combination of ticagrelor and aspirin did not show a decreased risk of SVG occlusion compared to aspirin alone.
  • Further research may explore optimal antiplatelet strategies in CABG patients.
Abstract

Keywords:
Ticagrelorcoronary artery bypass graftingmeta-analysisocclusionrandomized controlled trialsaphenous vein graft

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