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Postoperative antithrombotic therapy after coronary artery bypass grafting combined with coronary endarterectomy

Xieraili Tiemuerniyazi1, Ziang Yang1, Enze Yang2

  • 1Department of Cardiovascular Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, Beijing, Beijing, China.

BMJ Open
|November 10, 2025
PubMed

Insights

This randomized trial compares dual antiplatelet therapy versus dual antiplatelet therapy plus warfarin after coronary endarterectomy and bypass grafting. The study aims to find the best antithrombotic strategy to improve coronary graft patency.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Pharmacology

Background:

  • Coronary endarterectomy (CE) combined with coronary artery bypass grafting (CABG) is linked to poor graft patency.
  • Subendothelial tissue exposure during CE+CABG may activate coagulation, suggesting a need for anticoagulation.
  • Optimal antithrombotic therapy post-CE+CABG remains undetermined.

Purpose of the Study:

  • To determine the optimal antithrombotic therapy following coronary endarterectomy and coronary artery bypass grafting (CE+CABG).
  • To compare the efficacy of dual antiplatelet therapy (AT) versus dual AT plus warfarin (ATW) on coronary graft patency.

Main Methods:

  • A randomized controlled trial (PATH-CARE) involving 202 patients.
  • Patients assigned to AT (aspirin + clopidogrel) or ATW (aspirin + clopidogrel + warfarin for 3 months).
  • Primary endpoint: patency of CE-targeted coronary grafts assessed by angiography; secondary endpoints: major adverse events and bleeding.

Main Results:

  • N/A - Results pending study completion.

Conclusions:

  • N/A - Conclusions pending study completion.
Abstract

Keywords:
Cardiothoracic surgeryCoronary heart diseaseSURGERY

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