Evidence map›Paper›PMID 40411761›Full record

Trial reportEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2025

Extent of coronary artery disease and clinical outcomes with ticagrelor monotherapy versus aspirin after coronary artery bypass grafting: insights from the TiCAB trial.

Melanie Arnreiter, Moritz von Scheidt, Johannes M Albes, Tim Attmann, Andreas Boening, Yeong-Hoon Choi, Lenard Conradi, Bernhard C Danner, Andreas Fach, Ivar Friedrich and 15 more

Abstract readClinical Trial, Phase IIIComparative StudyMulticenter Study
In one paragraph

Trial report in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Melanie ArnreiterDepartment of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0009-0002-5869-1732
Moritz von ScheidtGerman Heart Centre Munich, TUM University Hospital, School of Medicine and Health, Technical University of Munich, Munich, Germany.ORCID 0000-0001-7159-8271
Johannes M AlbesDepartment of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Bernau, Germany.ORCID 0000-0003-4722-3896
Tim AttmannDepartment of Cardiac Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.ORCID 0000-0002-5991-2106
Andreas BoeningDepartment of Adult and Pediatric Cardiovascular Surgery, University Hospital of Giessen and Marburg, Giessen, Germany.
Yeong-Hoon ChoiDepartment of Cardiac Surgery, Kerckhoff Klinik Bad Nauheim, Bad Nauheim, Germany.ORCID 0000-0002-5796-9926
Lenard ConradiDepartment of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Bernhard C DannerDepartment of Thoracic and Cardiovascular Surgery, University Hospital of Goettingen, Goettingen, Germany.
Andreas FachBremen Institute for Heart and Circulation Research (BIHKF), Bremen, Germany.
Ivar FriedrichDepartment of Cardiothoracic Surgery, Herzzentrum Trier, Krankenhaus der Barmherzigen Brüder Trier, Trier, Germany.
Herko GrubitzschDepartment of Cardiothoracic and Vascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Roland HeckDepartment of Cardiothoracic and Vascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Alexander JoostMedical Clinic II, University Heart Center Lübeck, Lübeck, Germany.ORCID 0000-0003-2206-7153
Christoph KnosallaDepartment of Cardiothoracic and Vascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Martin MisfeldDepartment of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Martin OberhofferDepartment of Cardiovascular Surgery, University Hospital of Johannes Gutenberg-Universität Mainz, Mainz, Germany.
Julia RiebandtDepartment of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-8601-9989
Andreas SchaeferDepartment of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
Matthias SiepeDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0003-3305-9343
Thomas WaltherDepartment of Cardiovascular Surgery, University Hospital Frankfurt and Goethe University Frankfurt, Frankfurt, Germany.
Gerhard Wimmer-GreineckerDepartment for Cardiothoracic Surgery, Heart and Vessel Center Bad Bevensen, Bad Bevensen, Germany.
Uwe ZeymerDepartment of Cardiology, Klinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany.
Heribert SchunkertGerman Heart Centre Munich, TUM University Hospital, School of Medicine and Health, Technical University of Munich, Munich, Germany.ORCID 0000-0001-6428-3001
Adnan KastratiGerman Heart Centre Munich, TUM University Hospital, School of Medicine and Health, Technical University of Munich, Munich, Germany.ORCID 0000-0003-4341-891X
Sigrid SandnerDepartment of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0003-4669-9841

Funding

Deutsches Herzzentrum München, Germany
6 · The paper itself

Abstract

objectivesPatients with extensive coronary artery disease (CAD) have a higher risk of cardiovascular events. This post hoc analysis of the Ticagrelor in CABG (TiCAB) trial examined the association of ticagrelor monotherapy versus aspirin with clinical outcomes after coronary artery bypass grafting (CABG) in relation to the extent of CAD.

methodsThe TiCAB trial randomized CABG patients to ticagrelor (90 mg twice daily) or aspirin (100 mg daily) for 12 months. Patients were stratified by SYNTAX score terciles: low (≤22), intermediate (23-32) and high (≥33). The primary end-point was major adverse cardiac and cerebrovascular events (MACCE) at 12 months, including cardiovascular death, myocardial infarction, stroke or repeat revascularization. Secondary end-points included individual MACCE components and major bleeding events. Cox proportional hazards models were used to assess treatment effects.

resultsAmong 752 patients, 33.4% had low, 36.0% intermediate and 30.6% high SYNTAX scores (median 26.5 [20.0-33.0]). MACCE rates were similar across groups (low: 7.8%; intermediate: 9.2%; high: 8.8%; P = 0.87), though the incidence of repeat revascularization differed significantly among SYNTAX score groups (P = 0.02). Ticagrelor did not show a significant MACCE benefit over aspirin in any SYNTAX score group (low: HR 2.27, 95% CI 0.87-5.94; intermediate: HR 1.02, 95% CI 0.46-2.27; high: HR 1.76, 95% CI 0.70-4.46; Pint=0.41). Secondary outcomes, including bleeding, aligned with overall trial results.

conclusionsThis analysis did not find a differential benefit of ticagrelor versus aspirin across CAD complexity levels as measured by the SYNTAX score. Further studies are warranted to refine antiplatelet strategies for patients with complex CAD undergoing CABG.

Indexed as

AspirinCoronary Artery BypassCoronary Artery DiseasePlatelet Aggregation InhibitorsTicagrelorAgedFemaleHumansMaleMiddle AgedTreatment OutcomeAspirinPlatelet Aggregation InhibitorsTicagrelorAspirinComplex coronary artery diseaseCoronary artery bypass graftingSYNTAX scoreTicagrelor

Identifiers

PMID40411761
PMCPMC12212761

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.