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Dual Antiplatelet Therapy and Surgical Revasculatization: A Survey of Canadian Cardiac Surgeons

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Three landmark randomized controlled trials support the use of dual antiplatelet therapy (DAPT), the combination of aspirin and a P2Y12 inhibitor, post-acute coronary syndrome (ACS) regardless of whether they are managed medically, percutaneous or surgically.

  CURE (Yusuf, N Engl J Med. 2001;345:494)

  TRITON–TIMI 38 (Wiviott, N Engl J Med. 2007;257:2001)

  PLATO (Wallentin, N Engl J Med. 2009;361:1045)


A recent Focused 2012 Update of the Canadian Cardiovascular Society Guidelines support the use of DAPT for 12 months in patients with ACS after CABG (strong recommendation, moderate-quality evidence; Tanguay, Can J Cardiol. 2013;29:1334)


However, in practice, the use of DAPT in patients with ACS undergoing CABG is variable. Two large studies reported 25-26% usage (Krimly, Can J Cardiol. 2011;27:711; Sorensen, J Am Coll Cardiol. 2011;57:1202).


To better understand this discrepancy, we developed a survey probe the knowledge and practice patterns of cardiac surgeons on the use of DAPT in patients with ACS undergoing CABG

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