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<p>Dual antiplatelet therapy (DAPT) is recommended after acute coronary syndrome (ACS), but evidence in coronary artery bypass graft (CABG) patients is limited. The TACSI (Dual Antiplatelet Therapy with Ticagrelor and Acetylsalicylic Acid [ASA] vs. ASA only after isolated Coronary Artery Bypass Grafting in patients with Acute Coronary Syndrome) Trial randomized 2201 ACS patients undergoing isolated CABG across 22 Nordic centres to Ticagrelor plus aspirin or Aspirin alone for 1&#xa0;year. Ticagrelor plus aspirin did not reduce death, myocardial infarction, stroke, or repeat revascularization compared with aspirin alone at 1&#xa0;year, but nearly doubled the risk of major bleeding. This challenges the assumption that DAPT, which is recommended in all cases after ACS, provides added benefit after CABG.</p>

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Aspirin monotherapy or DAPT after CABG in ACS? Insights from the TACSI Trial

  • 期刊论文

  • 发表日期：

    2025年11月8日

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  • Pradeep Narayan

摘要

Dual antiplatelet therapy (DAPT) is recommended after acute coronary syndrome (ACS), but evidence in coronary artery bypass graft (CABG) patients is limited. The TACSI (Dual Antiplatelet Therapy with Ticagrelor and Acetylsalicylic Acid [ASA] vs. ASA only after isolated Coronary Artery Bypass Grafting in patients with Acute Coronary Syndrome) Trial randomized 2201 ACS patients undergoing isolated CABG across 22 Nordic centres to Ticagrelor plus aspirin or Aspirin alone for 1 year. Ticagrelor plus aspirin did not reduce death, myocardial infarction, stroke, or repeat revascularization compared with aspirin alone at 1 year, but nearly doubled the risk of major bleeding. This challenges the assumption that DAPT, which is recommended in all cases after ACS, provides added benefit after CABG.