Coronary artery bypass graft surgery in patients on ticagrelor therapy is not associated with adverse perioperative outcomes

Sammer Diab, Mattan Arazi, Leonid Sternik, Ehud Raanani, Erez Kachel, Liza Grosman-Rimon, Amjad Shalabi, Offer Amir, Shemy Carasso

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Management of patients treated with Ticagrelor is challenging, as stopping Ticagrelor prior to coronary bypass graft surgery (CABG) may increase the risk of acute stent thrombosis. The aim of the study was to compare bleeding complications in patients treated with ticagrelor combined with acetylsalicylic acid (ASA) versus ASA alone until 1 day before surgery. Methods: Bleeding complications, defined as the composite of red blood cell transfusion ≥1000 ml, chest drainage ≥2000 ml, and bleeding requiring surgical re-exploration, were compared in 161 patients, with 101 on preoperative acetylsalicylic acid (ASA) alone (group A) and 65 on ticagrelor + ASA (group B). Results: There were no differences in bleeding complications between the two groups (26% vs. 27% in group A and B, respectively), with similar chest drainage in the first 24 h (569 ± 393 ml and 649 ± 427 ml, respectively). Conclusions: Continuing ticagrelor until coronary artery bypass surgery was not associated with increased bleeding complications, suggesting that continued management with ticagrelor until surgery may be safe.

Original languageEnglish
Article number139
JournalJournal of Cardiothoracic Surgery
Volume16
Issue number1
DOIs
StatePublished - Dec 2021

Keywords

  • Acute coronary syndrome
  • Bleeding
  • Coronary artery bypass graft
  • Coronary artery bypass graft surgery
  • Dual anti platelet therapy
  • Ticagrelor

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