Comparison of Efficacy and Safety Between Two Dual Antiplatelet Therapy Intensive Treatments 4 Years After Coronary Artery Bypass Grafting
ZHONG Keng
LU Jie
ZHANG Boyao
FAN Xingli
ZHANG Guanxin
XUE Qing
Abstract：Objective This study aims to compare the effects of aspirin combined with clopidogrel(AC)versus aspirin combined with ticagrelor(AT)on great saphenous veins(GSVs)graft patency and the occurrence of adverse events at 4 years post coronary artery bypass grafting(CABG)on the basis of previous work,and to explore an optimal dual antiplatelet thera-py(DAPT)intensification strategy for Chinese patients after CABG.Methods Patients who successfully underwent elective CABG were randomized into AC group or AT groups.DAPT was initiated within 6 hours postoperatively according to the as-signed group.After one year,both groups were switched to single antiplatelet therapy with aspirin for long-term maintenance treatment.At 4 years post-CABG,GSV graft patency was assessed using 64-slice multidetector computed tomography angiogra-phy.The incidences of major adverse cardiovascular events(MACEs)and bleeding events were also recorded during follow-up.Results Among the 216 patients,3 died,and the remaining 213 patients completed the 4-year follow-up.The GSV graft paten-cy rate was 81.4%in the AC group,which was lower than that in the AT group(87.2%);however,this difference was not statis-tically significant(P>0.05).During the 4-year follow-up,21 MACEs and 55 bleeding events were documented.However,there was no statistically significant difference in the incidence of MACEs and bleeding events between two groups(P>0.05).Con-clusion Integrating the current 4-year follow-up data with our previous findings at 1 and 3 years post-CABG,although there is still no statistically significant difference in the GSV patency rate between the two DAPT intensive treatments,the difference is gradually widening.
Keywords：coronary artery bypass graftingpostoperationantiplatelet therapyaspirinclopidogrelticagrelor
Publication Date：2025-12-28
Online Publishing Date：2026-01-16(First online date of this platform, not the publication date of the document)
Pages：5( 478-482 )