Antiplatelet therapy around CABG: the latest evidence.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Opinion in Cardiology Pub Date : 2023-11-01 Epub Date: 2023-09-21 DOI:10.1097/HCO.0000000000001078

Sigrid Sandner, Björn Redfors, Mario Gaudino

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引用次数: 0

Abstract

Purpose of review: The optimal antiplatelet strategy in patients after coronary artery bypass graft (CABG) surgery is unclear. We review the evidence on the efficacy and safety of DAPT after CABG and discuss potential novel antiplatelet strategies that reduce the risk of bleeding without loss of efficacy.

Recent findings: Adding the potent P2Y12 inhibitor ticagrelor to aspirin for 1 year after CABG is associated with a reduction in the risk of vein graft failure, at the expense of an increased risk of clinically important bleeding. Ticagrelor monotherapy is not associated with better efficacy than aspirin alone, but is not associated with increased bleeding risk.

Summary: Dual antiplatelet therapy (DAPT) is recommended after acute coronary syndrome events, but aspirin as single antiplatelet therapy remains the cornerstone of antithrombotic therapy in stable ischemic heart disease because of a lack of solid evidence on the benefit of DAPT on clinical outcomes. Shorter duration DAPT, based on the pathophysiology of vein graft failure, may be a promising strategy that requires testing in adequately powered randomized trials.

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CABG的抗血小板治疗：最新证据。

综述目的：冠状动脉搭桥术后患者的最佳抗血小板策略尚不清楚。我们回顾了冠状动脉旁路移植术后DAPT的有效性和安全性的证据，并讨论了潜在的新型抗血小板策略，这些策略可以在不丧失疗效的情况下降低出血风险。最近的研究结果：冠状动脉旁路移植术后在阿司匹林中加入强效P2Y12抑制剂替卡格雷1年，可降低静脉移植物衰竭的风险，但会增加临床重要出血的风险。替卡格雷单药治疗的疗效并不比阿司匹林单药治疗好，但与出血风险增加无关。摘要：急性冠状动脉综合征事件后建议采用双重抗血小板治疗（DAPT），但阿司匹林作为单一抗血小板治疗仍然是稳定型缺血性心脏病抗血栓治疗的基石，因为缺乏DAPT对临床结果有益的确凿证据。基于静脉移植物衰竭的病理生理学，更短时间的DAPT可能是一种很有前途的策略，需要在充分的随机试验中进行测试。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Cardiology 医学-心血管系统

CiteScore

4.20

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.