Does Dual Antiplatelet Therapy Reduce Early Surgical Saphenous Vein Graft Failure?

Yes, according to a meta-analysis, but at the cost of increased clinically significant bleeding.

Up to 25% of saphenous vein graft (SVG) conduits occlude early after coronary bypass surgery. Whether use of dual antiplatelet therapy (DAPT) after surgery can reduce that risk is unclear.

In this meta-analysis, investigators pooled patient-level data from four randomized trials comparing DAPT of ticagrelor plus aspirin against aspirin alone for SVG failure at 1 year after coronary bypass. The primary outcome was assessed by computed tomographic or coronary imaging among 871 patients. Results were as follows:

The rate of SVG failure per graft was significantly lower (11%) with DAPT versus aspirin (20%), with a similar benefit of DAPT per patient (13% vs. 23%).
Incidence of major adverse cardiovascular and cerebrovascular events was not differe…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)