o:3473 Ticagrelor or aspirin after coronary artery bypass in patients with chronic kidney disease en BACKGROUND: The optimal antiplatelet therapy for patients with chronic kidney disease (CKD) undergoing coronary artery bypass grafting (CABG) remains unknown. METHODS: This post hoc analysis of the Ticagrelor in Coronary Artery Bypass (TiCAB) trial examined the efficacy and safety of ticagrelor versus aspirin in patients with or without CKD. Primary endpoint was the composite of cardiovascular death, stroke, myocardial infarction or revascularization (MACCE) at 1 year after CABG. Secondary endpoints included individual components of the primary endpoint, all-cause death, and major bleeding. Results: CKD was present in 276 of 1,843 randomized patients (15.0%). Patients with CKD versus those without CKD had higher 1-year rates of MACCE (13.0% vs. 8.3%, HR 1.63, 95% CI 1.12-2.39, P=0.01) and major bleeding (5.6% vs. 3.1%, HR 1.84, 95% CI 1.03-3.28, P=0.04). The 1-year rate of MACCE was increased with ticagrelor versus aspirin in patients with CKD (18.2% vs. 8.9%, HR 2.15, 95% CI 1.08-4.30, P=0.03), but not in patients without CKD (8.5% vs. 8.1%, HR 1.05, 95% CI 0.74-1.49, P=0.79) (Pinteraction=0.067). There was no difference in the 1-year rate of major bleeding with ticagrelor versus aspirin in patients with CKD (6.6% vs. 4.7%, HR 1.44, 95% CI 0.52-3.97, P=0.48) and without CKD (3.3% vs. 2.9%, HR 1.14, 95% CI 0.64-2.01, P=0.65). CONCLUSIONS: In patients with CKD and CABG, those who received ticagrelor had a higher incidence of MACCE but a similar incidence of major bleeding compared to those who received aspirin. Journal Pre-Proof Key words: ticagrelor, aspirin, coronary artery bypass 91552100 129074441 1552101 1552-6259 1552099 10.1016/j.athoracsur.2021.03.061 2023-12-03T07:28:26.077Z 44 yes 46 Sigrid E. Sandner 106341385 2022 46 Heribert Schunkert 46 Adnan Kastrati 46 Milan Milojević 106163721 0000-0003-0984-9011 2022 46 Andreas Böning 46 Daniel Zimpfer 46 Stephan Zellmer 46 Dominik Wiedemann 46 Günther Laufer 46 Moritz Von Scheidt 46 TiCAB Investigators institution application/pdf 5698845 https://unilib.phaidrabg.rs/o:3473 no yes 1 70 616.1-089:615.212 92000001 71A11 The annals of thoracic surgery 113 2 554 562 2022