Efficacy and safety of ticagrelor in patients with non-ST segment elevation acute coronary syndrome after coronary artery bypass grafting

In this study, we attempted to demonstrate prospects of proper dual antiplatelet drug therapy in acute coronary syndrome (ACS) without ST-segment elevation in patients who required surgical coronary intervention during primary hospitalization. The existing problems and their possible solutions were taken into account according to the state of the art; the interests of both a surgeon and a cardiologist were identified in a way they presented no harm to a patient. Objective of the study was to compare the efficacy and the safety of therapy with study drug, Ticagrelor, and with Clopidogrel in patients with ACS without ST-segment elevation in the presence of continuing therapy with Aspirin when Ticagrelor and Clopidogrel were cancelled before surgical intervention. This study included 83 patients with verified diagnosis and predicted development of unfavorable cardiovascular events in the nearest 30 days. Patients were randomized into 2 groups by envelope method. Group 1 was administered with Ticagrelor; group 2 was administered with Clopidogrel; all patients additionally received Aspirin. All patients underwent surgical treatment: coronary artery bypass grafting (CABG). In this study, we evaluated the effects of stopping drug therapy with Ticagrelor 1 to 3 days before CABG and Clopidogrel 5 days before surgery. Both advantages and disadvantages of these drugs were taken into account in regard to unfavorable coronary events both in both preoperative and postoperative periods. The work demonstrated the potential problems associated with greater blood loss during surgical intervention and after the use of study drug.