Abstract 11999: Effect of Ticagrelor With or Without Aspirin on Saphenous Vein Graft Patency One Year After Coronary-Artery Bypass Surgery Under Different Baseline Levels of Low-Density Lipoprotein Cholesterol: A Post-Hoc Analysis of the DACAB Trial (DACAB-LDL)

Objective: The post-hoc analysis aimed to explore the effect of ticagrelor plus aspirin (T+A) or ticagrelor alone (T) vs aspirin alone (A) on saphenous vein (SV) graft patency 1 year after coronary-artery bypass grafting (CABG) under different baseline levels of low-density lipoprotein cholesterol (LDL-C). Methods: All the 500 patients with 1460 SV grafts from the DACAB trial (NCT02201771) were stratified into subgroup LDL-Low (baseline LDL-C<1.8mmol/L, 148 patients with 430 SV grafts) & subgroup LDL-High (baseline LDL-C≥ 1.8mmol/L, 352 patients with 1030 SV grafts). The primary outcome was the 1-year SV graft patency (Fitzgibbon grade A). The generalized estimating equation model was applied in grafts outcome analyses. Results: The mean baseline LDL-C were 1.4mmol/L and 2.6mmol/L while mean follow-up LDL-C were 1.6mmol/L and 2.3mmol/L for subgroup LDL-Low and subgroup LDL-High, respectively. The baseline and 1-year statin use were comparable between the two subgroups (baseline, LDL-Low: 94.6% [140 of 148 patients], LDL-High: 93.5% [329 of 352 patients], P=0.633; 1-year, LDL-Low: 96.0% [142 of 148 patients], LDL-High: 95.7% [337 of 352 patients], P=0.916).For subgroup LDL-Low and subgroup LDL-High, the 1-year SV graft patency rates were constant significant higher with T+A vs A (LDL-Low: adjusted OR=0.41 [95%CI, 0.17 to 0.97]; LDL-High: adjusted OR=0.38 [95%CI, 0.20 to 0.71]; Inter P=0.679), but may not with T vs A (LDL-Low: adjusted OR=0.24 [95%CI, 0.08 to 0.67]; LDL-High: adjusted OR=0.93 [95%CI, 0.53 to 1.63]; Inter P=0.030). The 1-year SV graft patency were 83.8% (359 of 430 grafts) in subgroup LDL-Low and 82.3% (848 of 1030 grafts) in subgroup LDL-High. No statistically significant difference was observed between the two subgroups (adjusted OR=0.96 [95%CI, 0.62 to 1.50], P=0.857). Conclusion: For 1-year SV graft patency post-CABG, T+A was more effective than A alone in both subgroup LDL-Low and LDL-High; T alone might be more effective than A alone in subgroup LDL-Low. No statistically significant difference of 1-year SV graft patency were observed between subgroup LDL-Low and LDL-High in the DACAB trial. [ABSTRACT FROM AUTHOR]