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Safety outcomes of anti-platelet therapy post coronary artery bypass graft surgery: A systematic review and network meta-analysis of randomized control trials.
- Source :
-
Perfusion . May2024, Vol. 39 Issue 4, p684-697. 14p. - Publication Year :
- 2024
-
Abstract
- Background: Antiplatelet therapy is used to decrease the risk of graft failure post coronary artery bypass graft surgery. We aimed to compare dual antiplatelet therapy (DAPT) with monotherapy along with a comparison of Aspirin, Ticagrelor, Aspirin+Ticagrelor (A+T) and Aspirin+Clopidogrel (A+C) to determine the major and minor bleeding risk, risk of postoperative myocardial infarction (MI), stroke, and all-cause mortality (ACM). Methods: Randomized Controlled Trials comparing the four groups were included. Odds ratio (OR) and Absolute Risk (AR) were employed to assess the mean and standard deviation (SD) with 95% confidence intervals (CI). The Bayesian random-effects model was used for statistical analysis. Risk difference and Cochran Q tests were used to calculate rank probability (RP) and heterogeneity, respectively. Results: We included 10 trials, consisting of 21 arms and 3926 patients. For the risk of major and minor bleed, A + T and Ticagrelor showed the lowest mean value of 0.040 (0.043) and 0.067 (0.073), respectively, and the highest RP of being the safest group. While a direct comparison between DAPT and monotherapy resulted in an OR of 0.57 [0.34, 0.95] for the risk of minor bleed. A + T was found to have the highest RP and the lowest mean value in terms of ACM, MI, and stroke. Conclusion: No significant difference was found between monotherapy or dual-antiplatelet therapy for the major bleeding risk safety outcome, however DAPT was found to have a significantly higher rate of minor bleeding complications post-CABG. DAPT should be considered as the antiplatelet modality of choice post-CABG. [ABSTRACT FROM AUTHOR]
- Subjects :
- *MYOCARDIAL infarction risk factors
*HEMORRHAGE risk factors
*COMBINATION drug therapy
*PATIENT safety
*ASPIRIN
*ADENOSINE triphosphate
*TREATMENT effectiveness
*META-analysis
*DESCRIPTIVE statistics
*CORONARY artery bypass
*SYSTEMATIC reviews
*ODDS ratio
*PERCUTANEOUS coronary intervention
*PLATELET aggregation inhibitors
*STROKE
*CONFIDENCE intervals
*QUALITY assurance
*DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 02676591
- Volume :
- 39
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Perfusion
- Publication Type :
- Academic Journal
- Accession number :
- 177178491
- Full Text :
- https://doi.org/10.1177/02676591231159513