We evaluated perioperative bleeding after CABG in patients preoperatively treated with ticagrelor or clopidogrel, stratified by discontinuation of these P2Y12 inhibitors. In patients receiving ticagrelor 2 days before surgery and in those receiving clopidogrel 3 days before surgery, there was an increased rate of severe bleeding. Postponing non-emergent CABG for at least 3 days after discontinuation of ticagrelor and 4 days after clopidogrel should be considered.
Holm M, Biancari F, Khodabandeh S, Gherli R, Airaksinen J, Mariscalco G, Gatti G, Reichart D, Onorati F, De Feo M, Santarpino G, Rubino AS, Maselli D, Santini F, Nicolini F, Zanobini M, Kinnunen EM, Ruggieri VG, Perrotti A, Rosato S, Dalén M. Bleeding in Patients Treated with Ticagrelor or Clopidogrel Before Coronary Artery Bypass Grafting. Ann Thorac Surg 2019 Mar 19. pii: S0003-4975(19)30365-0. doi: 10.1016/j.athoracsur.2019.01.086. [Epub ahead of print]