Comparison of different dual antiplatelet therapies after coronary artery bypass grafting:5-year follow-up results of a single-center exploratory randomized controlled study
XUE Qing
FAN Xingli
ZHONG Keng
LU Jie
ZHANG Boyao
MA Ye
ZHANG Guanxin
LI Bailing
Abstract：Objective To compare the effects of aspirin combined with clopidogrel and aspirin combined with ticagrelor on the 5-year prognosis after coronary artery bypass grafting(CABG).Methods A total of 194 patients who underwent elective CABG at the First Affiliated Hospital of Naval Medical University from October 2017 to June 2020 were selected.Among them,129 were male and 65 were female,with an average age of(66.8±5.1)years,and the age range was 50 to 78 years.The patients were randomly divided into the clopidogrel group(n=100)and the ticagrelor group(n=94)using the block randomization method.Within 6 hours after CABG,the groups were initiated and dual antiplatelet therapy(DAPT)was started.1 year after CABG,both groups were switched to long-term single antiplatelet therapy with aspirin.5 years after CABG,the occurrence of major adverse cardiovascular event(MACE),bleeding event(BE),and the patency of the bypass vessel were observed.Results Two patients in the clopidogrel group died,and 3 patients in the ticagrelor group died.The incidence of MACE in the clopidogrel group[12.0%(12/100)]was not statistically different from that in the ticagrelor group[16.0%(15/94)](P>0.05).The incidence of BE in the clopidogrel group[25.0%(25/100)]was not statistically different from that in the ticagrelor group[27.7%(26/94)](P>0.05).The patency rate of the great saphenous vein(GSV)in the clopidogrel group[79.2%(179/226)]was lower than that in the ticagrelor group[86.7%(176/203)],and the difference was statistically significant(P<0.05).The patency rate of the left internal mammary artery in the clopidogrel group[91.7%(88/96)]was lower than that in the ticagrelor group[92.1%(82/89)],but the difference was not statistically significant(P>0.05).Conclusion From the perspective of GSV patency rate,there are significant differences between the two different DAPT intensification treatment strategies after CABG.Aspirin combined with ticagrelor is superior to aspirin combined with clopidogrel.
Keywords：coronary artery bypass graftingantiplatelet therapyaspirinclopidogrelticagrelor
Publication Date：2025-11-25
Online Publishing Date：2025-12-25(First online date of this platform, not the publication date of the document)
Pages：5( 409-413 )