In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Platelet aggregability evaluation in patients with acute coronary syndromes scheduled for coronary artery bypass graft. The PLAT-CABG study

Session Poster Session 2

Speaker Talia Dalcoquio

Event : ESC Congress 2019

  • Topic : interventional cardiology and cardiovascular surgery
  • Sub-topic : Cardiovascular Surgery – Coronary Arteries
  • Session type : Poster Session

Authors : C A K Nakashima (Sao Paulo,BR), L A O Dallan (Sao Paulo,BR), L A F Lisboa (Sao Paulo,BR), L A Hajjar (Sao Paulo,BR), A M Soeiro (Sao Paulo,BR), B A Silva (Sao Paulo,BR), M S S Costa (Sao Paulo,BR), CJCB Dornas (Brasilia,BR), T F Dalcoquio (Sao Paulo,BR), R H M Furtado (Sao Paulo,BR), L M Baracioli (Sao Paulo,BR), J T Fukushima (Sao Paulo,BR), P A Gurbel (Durham,US), R P Giugliano (Boston,US), J C Nicolau (Sao Paulo,BR)

C.A.K. Nakashima1 , L.A.O. Dallan1 , L.A.F. Lisboa1 , L.A. Hajjar1 , A.M. Soeiro1 , B.A. Silva1 , M.S.S. Costa1 , C.J.C.B. Dornas2 , T.F. Dalcoquio1 , R.H.M. Furtado1 , L.M. Baracioli1 , J.T. Fukushima1 , P.A. Gurbel3 , R.P. Giugliano4 , J.C. Nicolau1 , 1Heart Institute of the University of Sao Paulo (InCor) - Sao Paulo - Brazil , 2Hospital do Coracao do Brasil - Brasilia - Brazil , 3Duke University Medical Center - Durham - United States of America , 4Brigham and Womens Hospital - Boston - United States of America ,

On behalf: ANtiplatelet Therapy Study (ANTS) group

European Heart Journal ( 2019 ) 40 ( Supplement ), 1134

Background: Dual antiplatelet therapy is recommended for patients (pts) with acute coronary syndromes (ACS). However, 10–15% of pts have indication of coronary artery bypass graft (CABG) for the index event and current guidelines recommend stopping clopidogrel at least 5 days prior to CABG. This waiting time could increase hospital length of stay, thus having negative impacts on costs and clinical complications.

Purpose: To evaluate if release to CABG based on platelet aggregability by Multiplate AnalyzerTM would be non-inferior in comparison with common practice (5 days) in terms of 24-hours post-CABG bleeding.

Methods: The PLAT-CABG (NCT 02516267) is a randomized, open label, non-inferiority trial (boundary 25%) testing a strategy of platelet aggregability-guided release to CABG versus standard-of-care on the primary endpoint of chest tube drainage in the first 24 hours post CABG. A total of 190 pts admitted with ACS, treated with aspirin + clopidogrel and with indication for CABG, were assigned to clopidogrel discontinued 5 days prior to CABG (control group) vs. daily measurements of platelet aggregability to ADP using Multiplate AnalyzerTM (intervention group) with CABG occurring after recovering from platelet inhibition (pre-defined as a threshold of 46 AU).

Results: The main results are depicted in the table

Conclusion: Platelet-aggregability guided release to CABG is non-inferior to standard of care in ACS patients awaiting CABG in terms of peri-operative bleeding and significantly shortens the time to CABG.

Main results of PLAT-CABG study
VariablesControl Group (n=95)Intervention Group (n=95)P-value for superiorityP-value for non-inferiority
Chest tube drainage (mL), Median (25th–75th)350 (250–500)350 (250–500)0.6800.001
Time symptom to CABG (hours), Median (25th–75th)191 (150–281)166 (119–225)<0.001NA
Time surgery indication to CABG (hours), Median (25th–75th)136 (112–161)112 (66–142)<0.001NA
CABG = coronary artery bypass graft.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are