Ticagrelor-based De-escalation of Dual Antiplatelet Therapy After Coronary Artery Bypass Grafting

Summary

Ticagrelor-based De-escalation of Dual Antiplatelet Therapy After Coronary Artery Bypass Grafting trial (TOP-CABG trial) is a multicenter, randomized, double-blind, non-inferiority, parallel controlled trial. The aim of TOP-CABG is to investigate whether de-escalated dual antiplatelet therapy (De-DAPT) is non-inferior to dual antiplatelet therapy (DAPT) in efficacy on inhibiting great saphenous vein (SVG) graft occlusion and is superior in reducing bleeding events in patients accepting coronary artery bypassing grafting.

Timeline

Start

2023-02-14

Primary completion

2025-07-08

Completion

2025-07-10

Outcome

Met primary endpoint

paper A three month DAPT strategy was non-inferior to the 12 month DAPT strategy in saphenous vein graft occlusion and was superior in reducing bleeding risk. PMID 42120081 ↗

Publications

• Yuan X, Li J, Lei L, Zhang L, Chen K, Chu Q, Feng W, Wang X, Wang X, Xu F, Liu S, Yang Y, Wang X, Wang H, Dong A, Cheng Z, Guo H, Zhou T, Chen X, Ge J, Zhang L, Liu S, Shen Z, Wang J, Wang Y, Li W, Hu S; TOP-CABG Collaborative Group. Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial. BMJ. 2026 May 12;393:e088939. doi: 10.1136/bmj-2025-088939.
• Yuan X, Chu Q, Chen K, Wang Y, Zhang L, Zheng Y, Hu S. Multicentre, randomised, double-blind, parallel controlled trial to investigate timing of platelet inhibition after coronary artery bypass grafting: TOP-CABG trial study. BMJ Open. 2023 Jun 29;13(6):e070823. doi: 10.1136/bmjopen-2022-070823.

Drugs

Indications