Results from the TiCAB study have shown that Ticagrelor monotherapy is no better than aspirin in reducing the chances of graft failure in the first year following a coronary artery bypass grafting (CABG).

The drug, a P2Y12 inhibitor was thought to be more effective than aspirin at lowering platelet aggregation, believed to be a key mediator in graft failure. The TiCAB results showed that of 1900 patients involved, there wasn't any significant difference in the rate of CV death, MI, stroke, or repeat revascularisation between the two groups- one on aspirin and the other on ticagrelor. 

Another issue that the researchers pointed out was the use of aspiring and ticagrelor with opiates such as fentanyl after surgery. While aspirin is absorbed through the stomach and show a rapid onset of action even in patients on fentanyl, ticagrelor is absorbed through the intestines and its absorption is also delayed by opiates such as fentanyl. This could have been one important aspect that could have been disadvantageous for ticagrelor in the study. 

Information for the article was sourced from TCTMD. Read the original here.