TY - JOUR
T1 - Randomized trial of ticagrelor vs. aspirin in patients after coronary artery bypass grafting
T2 - The TiCAB trial
AU - Schunkert, Heribert
AU - Boening, Andreas
AU - Von Scheidt, Moritz
AU - Lanig, Clarissa
AU - Gusmini, Friederike
AU - DeWaha, Antoinette
AU - Kuna, Constantin
AU - Fach, Andreas
AU - Grothusen, Christina
AU - Oberhoffer, Martin
AU - Knosalla, Christoph
AU - Walther, Thomas
AU - Danner, Bernhard C.
AU - Misfeld, Martin
AU - Zeymer, Uwe
AU - Wimmer-Greinecker, Gerhard
AU - Siepe, Matthias
AU - Grubitzsch, Herko
AU - Joost, Alexander
AU - Schaefer, Andreas
AU - Conradi, Lenard
AU - Cremer, Jochen
AU - Hamm, Christian
AU - Lange, Rudiger
AU - Radke, Peter W.
AU - Schulz, Rainer
AU - Laufer, Gunther
AU - Grieshaber, Philippe
AU - Pader, Philip
AU - Attmann, Tim
AU - Schmoeckel, Michael
AU - Meyer, Alexander
AU - Ziegelhoffer, Tibor
AU - Hambrecht, Rainer
AU - Kastrati, Adnan
AU - Sandner, Sigrid E.
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: [email protected].
PY - 2019/8/1
Y1 - 2019/8/1
N2 - AIMS The antiplatelet treatment strategy providing optimal balance between thrombotic and bleeding risks in patients undergoing coronary artery bypass grafting (CABG) is unclear. We prospectively compared the efficacy of ticagrelor and aspirin after CABG. METHODS AND RESULTS We randomly assigned in double-blind fashion patients scheduled for CABG to either ticagrelor 90 mg twice daily or 100 mg aspirin (1:1) once daily. The primary outcome was the composite of cardiovascular death, myocardial infarction (MI), repeat revascularization, and stroke 12 months after CABG. The main safety endpoint was based on the Bleeding Academic Research Consortium classification, defined as BARC ≥4 for periprocedural and hospital stay-related bleedings and BARC ≥3 for post-discharge bleedings. The study was prematurely halted after recruitment of 1859 out of 3850 planned patients. Twelve months after CABG, the primary endpoint occurred in 86 out of 931 patients (9.7%) in the ticagrelor group and in 73 out of 928 patients (8.2%) in the aspirin group [hazard ratio 1.19; 95% confidence interval (CI) 0.87-1.62; P = 0.28]. All-cause mortality (ticagrelor 2.5% vs. aspirin 2.6%, hazard ratio 0.96, CI 0.53-1.72; P = 0.89), cardiovascular death (ticagrelor 1.2% vs. aspirin 1.4%, hazard ratio 0.85, CI 0.38-1.89; P = 0.68), MI (ticagrelor 2.1% vs. aspirin 3.4%, hazard ratio 0.63, CI 0.36-1.12, P = 0.12), and stroke (ticagrelor 3.1% vs. 2.6%, hazard ratio 1.21, CI 0.70-2.08; P = 0.49), showed no significant difference between the ticagrelor and aspirin group. The main safety endpoint was also not significantly different (ticagrelor 3.7% vs. aspirin 3.2%, hazard ratio 1.17, CI 0.71-1.92; P = 0.53). CONCLUSION In this prematurely terminated and thus underpowered randomized trial of ticagrelor vs. aspirin in patients after CABG no significant differences in major cardiovascular events or major bleeding could be demonstrated. CLINICALTRIALS.GOV IDENTIFIER NCT01755520.
AB - AIMS The antiplatelet treatment strategy providing optimal balance between thrombotic and bleeding risks in patients undergoing coronary artery bypass grafting (CABG) is unclear. We prospectively compared the efficacy of ticagrelor and aspirin after CABG. METHODS AND RESULTS We randomly assigned in double-blind fashion patients scheduled for CABG to either ticagrelor 90 mg twice daily or 100 mg aspirin (1:1) once daily. The primary outcome was the composite of cardiovascular death, myocardial infarction (MI), repeat revascularization, and stroke 12 months after CABG. The main safety endpoint was based on the Bleeding Academic Research Consortium classification, defined as BARC ≥4 for periprocedural and hospital stay-related bleedings and BARC ≥3 for post-discharge bleedings. The study was prematurely halted after recruitment of 1859 out of 3850 planned patients. Twelve months after CABG, the primary endpoint occurred in 86 out of 931 patients (9.7%) in the ticagrelor group and in 73 out of 928 patients (8.2%) in the aspirin group [hazard ratio 1.19; 95% confidence interval (CI) 0.87-1.62; P = 0.28]. All-cause mortality (ticagrelor 2.5% vs. aspirin 2.6%, hazard ratio 0.96, CI 0.53-1.72; P = 0.89), cardiovascular death (ticagrelor 1.2% vs. aspirin 1.4%, hazard ratio 0.85, CI 0.38-1.89; P = 0.68), MI (ticagrelor 2.1% vs. aspirin 3.4%, hazard ratio 0.63, CI 0.36-1.12, P = 0.12), and stroke (ticagrelor 3.1% vs. 2.6%, hazard ratio 1.21, CI 0.70-2.08; P = 0.49), showed no significant difference between the ticagrelor and aspirin group. The main safety endpoint was also not significantly different (ticagrelor 3.7% vs. aspirin 3.2%, hazard ratio 1.17, CI 0.71-1.92; P = 0.53). CONCLUSION In this prematurely terminated and thus underpowered randomized trial of ticagrelor vs. aspirin in patients after CABG no significant differences in major cardiovascular events or major bleeding could be demonstrated. CLINICALTRIALS.GOV IDENTIFIER NCT01755520.
UR - http://www.scopus.com/inward/record.url?scp=85072011133&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/randomized-trial-ticagrelor-vs-aspirin-patients-after-coronary-artery-bypass-grafting-ticab-trial
U2 - 10.1093/eurheartj/ehz185
DO - 10.1093/eurheartj/ehz185
M3 - Journal articles
C2 - 31145798
AN - SCOPUS:85072011133
SN - 0195-668X
VL - 40
SP - 2432
EP - 2440
JO - European Heart Journal
JF - European Heart Journal
IS - 29
ER -
