Effect of Adding Ticagrelor to Standard Aspirin on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting (POPular CABG)
Autor: | Albert H.M. van Straten, Chris M Hackeng, Marc A. Brouwer, Dean R P P Chan Pin Yin, Marieke E. Gimbel, Kasper F Beukema, Hendrik W. van Es, Mohamed A. Soliman-Hamad, Jan G.P. Tijssen, Laura M Willemsen, Martin J. Swaans, Clemens von Birgelen, Uday Sonker, Jurriën M. ten Berg, Benno J. Rensing, Joyce Peper, Vera H.M. Deneer, Margreet W.A. Bekker, Johannes C. Kelder, Pim van der Harst, Edgar J. Daeter, Patrick Klein, Eline A Vlot, Paul W.A. Janssen |
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Přispěvatelé: | Cardiovascular Centre (CVC), Erasmus MC other, Cardiothoracic Surgery, Cardiology, ACS - Heart failure & arrhythmias, Health Technology & Services Research, RS: Carim - B04 Clinical thrombosis and Haemostasis, Cardiologie |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty OCCLUSION Bypass grafting SURGERY Saphenous vein graft Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Placebo-controlled study Coronary Angiography GUIDELINES DISEASE ticagrelor Double blind saphenous vein Double-Blind Method QUALITY-OF-LIFE Physiology (medical) medicine Vascular Patency Humans Acute Coronary Syndrome vascular patency Aged Aspirin ANTIPLATELET THERAPY business.industry RADIAL-ARTERY Graft Occlusion Vascular Middle Aged PREVENTION PLUS CLOPIDOGREL n/a OA procedure Surgery coronary artery bypass medicine.anatomical_structure ON-PUMP Female Cardiology and Cardiovascular Medicine business Ticagrelor medicine.drug Artery |
Zdroj: | Circulation, 142(19), 1799-1807. LIPPINCOTT WILLIAMS & WILKINS Circulation, 142, 1799-1807 Circulation, 142, 19, pp. 1799-1807 Circulation, 142(19), 1799-1807. Lippincott Williams & Wilkins Circulation, 142(19), 1799-1807. Lippincott Williams and Wilkins |
ISSN: | 0009-7322 |
Popis: | BACKGROUND: Approximately 15% of saphenous vein grafts (SVGs) occlude during the first year after coronary artery bypass graft surgery (CABG) despite aspirin use. The POPular CABG trial (The Effect of Ticagrelor on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting Surgery) investigated whether ticagrelor added to standard aspirin improves SVG patency at 1 year after CABG. METHODS: In this investigator-initiated, randomized, double-blind, placebo-controlled, multicenter trial, patients with ≥1 SVGs were randomly assigned (1:1) after CABG to ticagrelor or placebo added to standard aspirin (80 or 100 mg). The primary outcome was SVG occlusion at 1 year, assessed with coronary computed tomography angiography, in all patients who had primary outcome imaging available. A generalized estimating equation model was used to perform the primary analysis per SVG. The secondary outcome was 1-year SVG failure, which was a composite of SVG occlusion, SVG revascularization, myocardial infarction in myocardial territory supplied by a SVG, or sudden death. RESULTS: Among 499 randomized patients, the mean age was 67.9±8.3 years, 87.1% were male, the indication for CABG was acute coronary syndrome in 31.3%, and 95.2% of procedures used cardiopulmonary bypass. Primary outcome imaging was available in 219 patients in the ticagrelor group and 224 patients in the placebo group. The SVG occlusion rate in the ticagrelor group was 9.6% (44 of 457 SVGs) versus 10.1% in the placebo group (50 of 497 SVGs; odds ratio, 0.87 [95% CI, 0.49–1.55]; P =0.64). SVG failure occurred in 32 patients (12.9%) in the ticagrelor group versus 32 patients (13.0%) in the placebo group (hazard ratio, 1.04 [95% CI, 0.63–1.69]). CONCLUSIONS: In this randomized, placebo-controlled trial, the addition of ticagrelor to standard aspirin did not reduce SVG occlusion at 1 year after CABG. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02352402. URL: https://eudract.ema.europa.eu/ ; Unique identifier: 2014-002142-50. |
Databáze: | OpenAIRE |
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