No support found for dual antiplatelet therapy after cardiac bypass surgery over aspirin alone

Medical Xpress / Karolinska Institutet / New England Journal of Medicine ^ | Sept. 1, 2025 | Anders Jeppsson et al

[ConservativeMind]

Dual antiplatelet therapy after cardiac bypass surgery is no more effective than acetylsalicylic acid alone and also increases the risk of serious bleeding. This is shown in a study by researchers.

Today, dual antiplatelet therapy is recommended in international treatment guidelines after heart bypass surgery for acute coronary artery disease. The current study compares two different antithrombotic, i.e., blood-thinning, treatments. One is single antiplatelet therapy with acetylsalicylic acid (Aspirin) alone, the other is dual antiplatelet therapy with acetylsalicylic acid and ticagrelor (Brilique).

"There is no doubt that this patient group needs antiplatelet therapy. However, it has so far been unclear whether dual drug therapy after surgery further reduces the risk of death, blood clots, and other cardiovascular complications," says Anders Jeppsson.

The 2,201 patients in the study were randomly assigned to receive either ticagrelor and acetylsalicylic acid or acetylsalicylic acid alone. The follow-up period was 12 months from the date of surgery.

The results show no difference between the groups in terms of the study's primary focus: a composite measure of the risks of death, heart attack, stroke, or the need for another coronary artery procedure. The proportion affected within one year was just under 5% in both groups.

However, the researchers found that the groups differed when major bleeding as a side effect was included. Major bleeding occurred in 4.9% of those who received dual therapy, compared with 2% in the other group.

"The results are important because they probably mean that we should change our treatment of patients after coronary artery surgery. The currently recommended treatment with dual antiplatelet therapy offers no benefits—on the contrary, it increases the risk of serious bleeding complications compared with treatment with acetylsalicylic acid alone," says Ulrik Sartipy,

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TOPICS: Health/Medicine
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[ConservativeMind]

Just take aspirin after cardiac bypass. You will be safer.

[ConservativeMind]

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