Study Comparing Ticagrelor With Aspirin for Prevention of Vascular Events in Patients Undergoing CABG (TiCAB)

This is an interventional treatment trial for Coronary Artery Disease focused on measuring CABG, CAD, antiplatelet drug, Ticagrelor, Aspirin Read More

Inclusion Criteria:

1. Patients 18 years of age or older
2. Informed, written consent by the patient

3. Indication for CABG surgery:

   • coronary three vessel disease, or
   • left main stenosis, or
   • two vessel disease with impaired left ventricular function (<50%)

Exclusion Criteria:

1. Cardiogenic shock, haemodynamic instability
2. Indication for oral anticoagulation or dual antiplatelet therapy that can not be stopped after CABG
3. Need for concomitant non-coronary surgery (e.g. valve replacement)
4. Intolerance of or Allergy to Ticagrelor or ASA or any of their ingredients
5. History of bleeding diathesis within three months prior presentation
6. History of significant gastrointestinal bleeding within six months prior presentation
7. History of intracranial hemorrhage
8. History of moderate to severe liver impairment (Child Pugh B or C)
9. Chronic renal insufficiency requiring dialysis
10. Patient with an increased risk of bradycardic events (e.g. patients without a pacemaker who have sick sinus syndrome, 2nd or 3rd degree AV block or bradycardic-related syncope)
11. Known, clinically important thrombocytopenia (i.e. <100.000/µl)
12. Known, clinically important anaemia (i.e. <10mg/dl)
13. Participation in another investigational drug or device study in the last 30 days
14. Pregnancy or lactation (for premenopausal women 2 methods of reliable contraception, one of which must be barrier method, are required); in women with childbearing potential a pregnancy test is mandatory

15. Concomitant oral or intravenous therapy (see examples below) with strong CYP3A inhibitors, CYP3A substrates with narrow therapeutic indices, or strong CYP3A inducers which cannot be stopped for the course of the study

    • Strong inhibitors: ketoconazole, itraconazole, voriconazole, telithromycin, clarithromycin, nefazadone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir, over 1 litre daily of grapefruit juice.
    • Substrates with narrow therapeutic index: cyclosporine, quinidine.
    • Strong inducers: rifampin/rifampicin, phenytoin, carbamazepine.
16. Life expectancy less than 12 months that may result in protocol non-compliance or a risk for being lost to follow-up, active cancer
17. Indication for major surgery (e.g. cancer treatment, carotid surgery, cerebral surgery, major vascular surgery)
18. Previous enrollment or randomization of treatment in the present study.