Overview

• In the randomized TACSI trial across 22 Nordic centers, patients received either aspirin alone or aspirin plus ticagrelor after coronary artery bypass for acute coronary syndrome with 12 months of follow-up.
• The primary composite outcome of death, myocardial infarction, stroke, or repeat coronary procedure occurred in just under 5% of patients in both groups, showing no efficacy advantage for dual therapy.
• Major bleeding was more frequent with dual therapy at 4.9% compared with 2.0% on aspirin alone, and broader analyses including bleeding showed higher overall event rates at 9.1% versus 6.4%.
• Participants had a mean age of 66 years, and women accounted for 14.4% of the cohort, factors the investigators noted when discussing generalizability.
• Results were published in the New England Journal of Medicine and presented at the ESC Congress in Madrid, with investigators urging reconsideration of routine dual therapy and calling for longer-term follow-up.