Is dual antiplatelet therapy beneficial for post-CABG diabetes patients?

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Takeaway

  • Routine dual antiplatelet therapy (DAPT) may not be clinically warranted in diabetes patients with multivessel disease undergoing coronary artery bypass grafting (CABG).

Why this matters

  • Diabetes is independently associated with increased perioperative and long-term mortality in CABG patients.

Study design

  • Post-hoc, nonrandomized analysis from FREEDOM (Future REvascularization Evaluation in patients with diabetes mellitus: Optimal management of Multivessel disease) trial, comparing 544 patients receiving DAPT (aspirin+thienopyridine) with 251 on aspirin monotherapy at 30 days post-operatively.

Key results

  • No significant differences in 5-year primary composite outcome of all-cause death, myocardial infarction, or stroke (12.5% vs. 16.0%, adjusted hazard ratio [HR] 0.83, p=.39).
  • No significant differences in secondary outcomes of all-caus...