1 Despite great advancements in the availability and efficacy of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) remains the best management strategy for certain patients with severe multivessel coronary … twq('track','PageView'); DAPT was defined as DAPT given after surgery and prior to discharge. to download free article PDFs, All Rights Reserved, 2018;320(10):1035-1036. doi:10.1001/jama.2018.10438, Challenges in Clinical Electrocardiography, Clinical Implications of Basic Neuroscience, Health Care Economics, Insurance, Payment, Scientific Discovery and the Future of Medicine, United States Preventive Services Task Force. 'content-date':'2017-08-26', Stroke, or transient ischaemic attack (TIA) Conclusions: Current guidelines on DAPT in CABG are generally satisfying. }); Based on the 2016 ACC/AHA update, ... J.L. !function(f,b,e,v,n,t,s) Abbreviations and acronyms1. Invasive coronary angiography then revealed three-vessel coronary artery disease for which he underwent successful off-pump coronary artery bypass graft surgery (CABG). Dual Antiplatelet Therapy After Coronary Artery Bypass Grafting in the Setting of Acute Coronary Syndrome Am J Cardiol. No. Benefits of dual antiplatelet therapy (DAPT) have not been well established in all CABG patients. 18 .Volume–outcome relationship for revascularization procedures. After 1 year, we . No dedicated randomized study exists to guide the duration of DAPT after CABG. !function(e,t,n,s,u,a){e.twq||(s=e.twq=function(){s.exe?s.exe.apply(s,arguments):s.queue.push(arguments); In 1 analysis of 44 365 patients who underwent CABG after MI (22 984 with STEMI; 21 381 with NSTEMI), the inhospital mortality rate was similar in the 2 groups undergoing CABG <6 hours after diagnosis (12.5% and 11.5%, respectively), but it was higher in STEMI patients than in NSTEMI patients when CABG was performed 6 to 23 hours after diagnosis (13.6% versus 6.2%; P=0.006). In 2016, the ACC/AHA released updated guidelines on duration of dual antiplatelet therapy (DAPT) in patients with coronary artery disease. 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention, 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft … }); All Rights Reserved. Preamble2. Zhao's group noted that saphenous vein graft procedures are the most commonly used graft in CABG, but the use of the vein is associated with a failure rate of 10% to 25% at 1 year, and 50% at 1 years after the surgery. In patients with ACS (NSTE-ACS or STEMI) being treated with DAPT who undergo coronary artery bypass grafting (CABG), P2Y 12 inhibitor therapy should be resumed after CABG to complete 12 months of DAPT therapy after ACS (Class I). _gaq.push(['_trackPageview', link]); IIb B-NR In patients with SIHD, DAPT (with clopidogrel initiated early postoperatively) for 12 months after CABG may be reasonable to improve vein graft patency. var _gaq = _gaq || []; The use of dual antiplatelet therapy (DAPT), either with clopidogrel or ticagrelor (Brilinta; AstraZeneca), appears to reduce the risk of failing saphenous vein grafts among patients who undergo CABG surgery, a new network meta-analysis suggests. 'topics':'Myocardial Disease,Cardiovascular Pharmacotherapy,Acute Coronary Syndromes', var link = $(this).attr("href"); The mortality rate was 10.8% for patients undergoing CABG within 6 hours of the onset of symptoms, 23.8% in those undergoing CABG 7 to 24 hours after symptom onset, 6.7% in patients undergoing CABG from 1 to 3 days, 4.2% in those who underwent surgery from 4 to 7 days, and 2.4% after 8 days. The release of the ACC/AHA Focused Update on the Duration of Dual Antiplatelet Therapy (DAPT) represents an important event, in that its findings impact six already released ACC/AHA Clinical Practice Guidelines:. (window.BOOMR_mq=window.BOOMR_mq||[]).push(["addVar",{"rua.upush":"false","rua.cpush":"false","rua.upre":"false","rua.cpre":"false","rua.uprl":"false","rua.cprl":"false","rua.cprf":"false","rua.trans":"","rua.cook":"false","rua.ims":"false","rua.ufprl":"false","rua.cfprl":"false"}]);