{"id":8616,"date":"2025-09-13T15:27:46","date_gmt":"2025-09-13T12:27:46","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8616"},"modified":"2025-09-13T15:27:46","modified_gmt":"2025-09-13T12:27:46","slug":"dapt-after-cabg-tacsi-top-cabg-trials","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/dapt-after-cabg-tacsi-top-cabg-trials\/","title":{"rendered":"DAPT After CABG \u2013 TACSI & TOP-CABG Trials"},"content":{"rendered":"
DAPT After CABG \u2013 TACSI & TOP-CABG Trials<\/div>\n
<\/div>\n
Source: Medscape, ESC Congress 2025 \u2013 September 10, 2025<\/div>\n
1. Background<\/span><\/div>\n
\u2022 Current guidelines: 12 months of DAPT after CABG in ACS patients.<\/span><\/div>\n
\u2022 Evidence mainly extrapolated from PCI and non-CABG trials.<\/span><\/div>\n
2. TACSI Trial (Nordic countries, 2,201 ACS patients)<\/span><\/div>\n
\u2022 Compared: Aspirin + Ticagrelor (12 months) vs Aspirin alone.<\/span><\/div>\n
\u2022 Primary outcome (death, MI, stroke, repeat revascularization): 4.8% vs 4.6% \u2192 no difference.<\/span><\/div>\n
\u2022 Major bleeding: higher with DAPT (4.9% vs 2.0%; HR 2.50).<\/span><\/div>\n
\u2022 Net adverse events (ischemia + bleeding): worse with DAPT (9.1% vs 6.4%).<\/span><\/div>\n
\u2022 Conclusion: No added benefit, more bleeding \u2192 aspirin should remain standard after CABG.<\/span><\/div>\n
3. TOP-CABG Trial (China, 2,300 elective CABG patients)<\/span><\/div>\n
\u2022 Compared: 3 months DAPT \u2192 aspirin vs 12 months DAPT.<\/span><\/div>\n
\u2022 Vein graft occlusion at 1 year: similar (10.8% vs 11.2%).<\/span><\/div>\n
\u2022 Clinically relevant bleeding: lower with 3 months (8.3% vs 13.2%; P<0.001).<\/span><\/div>\n
\u2022 Conclusion: 3-month DAPT safer; balances graft protection with bleeding risk.<\/span><\/div>\n
4. Expert Perspectives<\/span><\/div>\n
\u2022 TACSI: \u201cNo clear role for routine DAPT after CABG; aspirin-only is standard.\u201d<\/span><\/div>\n
\u2022 TOP-CABG: Shorter (3-month) DAPT appears as effective as 12 months, with less bleeding.<\/span><\/div>\n
\u2022 Need for trials with aspirin-only arms and long-term follow-up.<\/span><\/div>\n
5. Take-home Message<\/span><\/div>\n
\u2022 12-month DAPT after CABG is not supported by strong evidence.<\/span><\/div>\n
\u2022 Aspirin alone is sufficient for most patients.<\/span><\/div>\n
<\/div>\n
\u2022 3-month DAPT may be considered in selected patients at low bleeding risk.<\/span><\/div>\n
\u2022 Future guidelines likely to revisit current recommendations.<\/span><\/div>\n
<\/div>\n
Clinical implication: CABG patients differ biologically from PCI patients \u2014 no stent left behind, so prolonged DAPT may not be necessary.<\/div>\n
<\/div>\n
https:\/\/www.medscape.com\/viewarticle\/reduce-dapt-3-months-after-mi-dual-acs-2025a1000nzw?src=mbl_msp_iphone&ref=whatsapp<\/a><\/div>\n
<\/div>\n","protected":false},"excerpt":{"rendered":"

DAPT After CABG \u2013 TACSI & TOP-CABG Trials Source: Medscape, ESC Congress 2025 \u2013 September 10, 2025 1. Background \u2022 Current guidelines: 12 months of DAPT after CABG in ACS patients. \u2022 Evidence mainly extrapolated from PCI and non-CABG trials. 2. TACSI Trial (Nordic countries, 2,201 ACS patients) \u2022 Compared: Aspirin + Ticagrelor (12 months) […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8616","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8616","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8616"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8616\/revisions"}],"predecessor-version":[{"id":8617,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8616\/revisions\/8617"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8616"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8616"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8616"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}