Pharmacotherapy

P2Y12 inhibitors post-CABG tied to lower cardiovascular risk

August 1, 2025

Study details: This population-based cohort study assessed >15,000 patients (mean age, 66 years; 83% male) in Ontario, Canada, who underwent isolated coronary artery bypass graft (CABG) between 2012 and 2020. Patients were grouped based on whether they received P2Y12 inhibitors postoperatively. Primary endpoint: time to MACE, analyzed with Cox models and inverse probability treatment weighting.

Results; After adjustment for covariates, P2Y12 inhibitor use was associated with a lower risk of MACE at 1 year (hazard ratio [HR], 0.39; 95% confidence interval [CI], 0.27–0.55) and at 5 years (HR, 0.65; 95% CI, 0.54–0.79). Benefits extended to all-cause and cardiovascular mortality, as well as broader ischemic outcomes. Adherence level didn’t influence the associations.

Clinical impact: The findings support the selective use of P2Y12 inhibitors after CABG to reduce ischemic complications. Clinicians may consider incorporating this strategy, particularly for patients at elevated cardiovascular risk, without heightened concern for bleeding.

Source:

Barry AR, et al. (2025, July 28). Pharmacotherapy. Effect of P2Y12 Inhibitors on Major Adverse Cardiovascular Events After Coronary Artery Bypass Graft Surgery: A Population-Based Cohort Study. https://pubmed.ncbi.nlm.nih.gov/40719229/