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Potent Antiplatelets Pre-CABG for ACS? Meta-analysis Stirs Debate

February 26, 2021 Giving potent antiplatelets up front to ACS patients, regardless of whether they may require CABG, could provide a survival benefit through early induction of platelet quiescence, according to results of a meta-analysis. Senior study author Derek So, MD (University of Ottawa Heart Institute, Ontario, Canada), said the results build on data from the PLATO and TRITON-TIMI 38 trials, both of which suggested potent antiplatelets could bolster survival. Analysis of those two studies plus eight others found greater mortality overall when patients who were admitted for ACS and then underwent CABG had been given weaker antiplatelet strategies, such as aspirin alone or aspirin and clopidogrel, versus potent strategies like aspirin and P2Y12 inhibitors (OR 1.38; 95% CI 1.03-1.85).

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