Research Article: Multicentre, randomised, double-blind, parallel controlled trial to investigate timing of platelet inhibition after coronary artery bypass grafting: TOP-CABG trial study
Abstract:
Introduction Dual antiplatelet therapy (DAPT), referred to as the combination of aspirin and P2Y 12 receptor antagonist (clopidogrel or ticagrelor), potentially improves patency of saphenous vein grafts (SVG) after coronary artery bypass grafting (CABG), while it is further proposed that DAPT potentially increases bleeding risk. Compared with DAPT, de-escalated DAPT (De-DAPT) is an effective antiplatelet strategy for acute coronary syndrome treatment, which significantly reduces the risk of bleeding without increasing the incidence of major adverse cardiovascular events. However, insufficient evidence is available to determine the timing of DAPT after CABG. Ethics and dissemination The Ethics Committee in Fuwai hospital approved this study (2022-1774). Fifteen centres agreed to participate the TOP-CABG trial, and the study has been approved in these 15 centres by whose ethics committee. The results of the trial will be submitted for publication in a peer-reviewed journal. Trial registration number NCT05380063 .
Introduction:
Data show that up to 20% of saphenous vein grafts (SVG) occlude within 1?year after coronary artery bypass grafting (CABG), which is associated with adverse outcomes such as angina pectoris, myocardial infarction and long-term mortality. 1–4 Although occlusion of SVG is regarded as a complex process, platelet activation and thrombosis likely contribute to early process of SVG stenosis or occlusion. Antiplatelet therapy with aspirin is recommended after CABG, 5 6 but even if aspirin were given, the SVG patency…
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