Blood Loss, Surgical Clinical Trial
Official title:
Comparison of Coronary Artery Bypass Graft Surgery Related Bleeding Complications in Patients Treated With Ticagrelor or Clopidogrel
In patients with coronary artery disease, dual antiplatelet therapy (acetylsalicylic acid and
a P2Y12-receptor antagonist) is a commonly used method because of its excellent
antithrombotic effect. In particular, in patients with acute myocardial infarction, who
receive coronary angiography as an emergency, the dual antiplatelet is used immediately
before the test to prevent and test further clot formation, regardless of whether or not the
patient had previously taken dual antiplatelet.
Ticagrelor, a direct-acting and reversible ADP receptor antagonist, was introduced in Denmark
in 2013 and is now the most commonly used ADP receptor antagonist in the treatment of ACS.
Compared to its predecessor clopidogrel, the pharmacokinetic profil of ticagrelor is more
predictable, demonstrating a faster onset of action and a more consistent platelet
inhibition. However, because of the excellent antithrombotic effect and increased bleeding
potential, it is recommended that major bleeding, such as OPCAB or CABG surgery, be expected
with a high probability, and in case of fatal surgery, the drug should be discontinued for 5
days.
Most patients who receive emergency coronary heart surgery after undergoing coronary
angiography as an emergency due to an acute myocardial infarction, it take approximately
24-48 hours to undergo surgery after examination. In fact, there have been reports of
large-scale cross-country studies that do not increase bleeding risk compared to 5 days until
3 days after ticagrelor is stopped. Therefore, this study aimed to retrospectively analyze
the bleeding tendency by analyzing the records of patients using clopidogrel or ticagrelor in
preoperative coronary angiography for patients undergoing emergency CABG surgery from 2016 to
September 2019.
n/a
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