Coronary disease & ACS

Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial

BMJPublished Randomised controlled trial

Primary result · Saphenous vein graft occlusionResult — go to the resultAbsolute difference −0.31% 95% CI −3.13% to 2.52%

Authors' conclusion

A three month DAPT strategy was non-inferior to the 12 month DAPT strategy in saphenous vein graft occlusion and was superior in reducing bleeding risk.

Study context

Population
Adults aged 18–80 years undergoing elective primary CABG with ≥1 saphenous vein graft2,290 in modified ITT set
Participants
2,300 adults
Comparison
3-month vs 12-month dual antiplatelet therapy (DAPT) after CABG
Primary endpoint
Saphenous vein graft occlusion (non-inferiority) and BARC type 2, 3 or 5 bleeding (superiority)
Follow-up
1 year
Methodological detailsmulticentre, non-inferiority, double-blind, 13 cardiac surgery centres in China
  • Multicentre
  • Non-inferiority
  • Double-blind
  • 13 cardiac surgery centres in China

Primary result

Saphenous vein graft occlusion

Absolute difference

−0.31%

95% CI −3.13% to 2.52%

P = 0.008 for non-inferiority

Events by treatment group

3-month DAPT vs 12-month DAPT
absolute difference −0.31% (95% CI −3.13% to 2.52%); P for non-inferiority = 0.008

As reported in the abstract

Secondary outcomes

Outcome3-month DAPT12-month DAPTAbsolute difference (95% CI)
MACCE2.3%2.7%−0.11% (−1.48% to 1.26%)

Other secondary outcomes (graft failure, stenosis, occlusion)

Similar between the two groups

Safety

Outcome3-month DAPT12-month DAPTAbsolute difference (95% CI)P value
BARC type 2, 3 or 5 bleeding (co-primary, superiority) · median follow-up 368 days (IQR 358-382)8.3%13.2%−4.67% (−7.18% to −2.16%)P < 0.001
Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding (co-primary, superiority) — NNT to prevent one bleeding event
21 (95% CI 13 to 46)

Original publication

Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial. BMJ. Published 12 May 2026. doi:10.1136/bmj-2025-088939

Summarised from the published abstract; every number is checked against it

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