Coronary disease & ACSRandomised controlled trial
Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome
- Randomised controlled trial
- open-label
- registry-based
- 22 Nordic cardiothoracic surgery centres
Authors' conclusion
Among patients who underwent CABG for an acute coronary syndrome, ticagrelor plus aspirin did not result in a lower incidence of death, myocardial infarction, stroke, or repeat coronary revascularization than aspirin alone at 1 year.
Study context
- Population
- Patients undergoing coronary-artery bypass grafting (CABG) for ACS
- Participants
- 2,201 patients
- Comparison
- Ticagrelor plus aspirin vs aspirin alone for 1 year after CABG
- Ticagrelor plus aspirinn = 1,104
- Aspirin alonen = 1,097reference
- Primary endpoint
- Composite of:
- Death
- MI
- Stroke
- Repeat revascularization
- Follow-up
- 1 year
Primary result
As reported in the abstract
Hazard ratio
1.06
95% CI 0.72–1.56
P = 0.77
Events by treatment group
Ticagrelor plus aspirin vs Aspirin alone
HR 1.06 (95% CI 0.72–1.56); P = 0.77
Secondary outcomes
| Outcome | Ticagrelor plus aspirin | Aspirin alone | HR (95% CI) | |
|---|---|---|---|---|
| Net adverse clinical events (primary-outcome event or major bleeding; key secondary) | 9.1% | 6.4% | 1.45 (1.07–1.97) | |
| 0.512Hazard ratio (log scale) |
Safety
| Outcome | Ticagrelor plus aspirin | Aspirin alone | HR (95% CI) | |
|---|---|---|---|---|
| Major bleeding | 4.9% | 2.0% | 2.50 (1.52–4.11) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome. N Engl J Med. Published 1 September 2025. doi:10.1056/nejmoa2508026
Summarised from the published abstract; every number is checked against it