CLINICAL TRIAL article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1461370
Ticagrelor combined with aspirin may improve patency of vein graft one year after off-pump coronary artery bypass grafting: A single-center, randomized double-blinded clinical controlled trial
Provisionally accepted
Wenjun Wang1Qingzhuo Chi2Feng Gao1Xuezhi He1Yang Gao1Lei Shi1Wei Liu1Weiwang Fan1Lin Zhang1Chang Xu1
Xijing Zhuang1*- 1Dalian Municipal Central Hospital, Dalian, China
- 2Dalian University of Technology, Dalian, Liaoning Province, China
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Background: Dual anti-platelet therapy (DAPT) after coronary artery bypass graft surgery (CABG) has drawn a lot of controversy. This study aimed to explore the effects of ticagrelor combined with aspirin (compared with aspirin combined with clopidogrel) on the patency of saphenous vein graft (SVG) after off-pump CABG.Methods: This was a prospective, randomized, double-blinded clinical controlled trial.Participants were first given aspirin (100 mg/d) within 12 h after off-pump CABG, followed by P2Y12 receptor antagonist (Orally, 75 mg/time of clopidogrel, once daily, for Group C and 90 mg/time of ticagrelor, twice daily, for Group T) within 24h after off-pump CABG for one year. Computed tomography angiography (CTA) was conducted for all patients. The incidence of major adverse cardiac events(MACE), death, stroke, hemorrhage, left ventricular diameter (LVD), and left ventricular ejection fraction (LVEF) of the participants was assessed one year after off-pump CABG based on a 12-month follow-up.Results: A total of 73 participants completed the follow-up, and 219 bypass grafts, including 146 SVGs, were conducted. Notably, 11 bypass grafts (SVGs) were exposed to occlusion (9 in Group C and 2 in Group T). The overall occlusion rates of bypass grafts and SVGs of Groups C and T were significantly different (9/114 vs. 2/105, P=0.043, 9/76 vs. 2/70, P=0.04). Moreover, multivariate binary Logistic regression demonstrated that ticagrelor + aspirin anti-platelet therapy could reduce the stenosis risk of bypass grafts (OR=0.195, 95% CI=0.039-0.978, P=0.047).Compared with clopidogrel, ticagrelor may reduce the occlusion rate of vein grafts after CABG.
Keywords: Coronary artery bypass surgery, Off-pump, Saphenous vein graft, ticagrelor, clopidogrel
Received: 08 Jul 2024; Accepted: 24 Apr 2025.
Copyright: © 2025 Wang, Chi, Gao, He, Gao, Shi, Liu, Fan, Zhang, Xu and Zhuang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xijing Zhuang, Dalian Municipal Central Hospital, Dalian, China
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