Comparative outcomes of anticoagulant versus antiplatelet therapy in coronary endarterectomy: a meta-analysis

Description

Giuseppe Comentale and colleagues compared blood-thinning strategies after coronary endarterectomy, an operation that peels diseased lining out of a heart artery when bypass grafting cannot clear it. No guideline settles whether patients should then take anticoagulants or platelet-blocking drugs. Their 2026 analysis searched three databases with no limits on year or language and merged nineteen studies, with two reviewers screening blind and a third settling disputes.

Death rates, early and late, came out alike under both strategies. Early heart attacks, though, struck clearly less often in patients on dual platelet therapy, the paired aspirin-based regimens. Swapping the second platelet drug between clopidogrel and ticagrelor made no clear difference to whether grafts stayed open. The authors lean toward dual platelet therapy as the better buy, since it buys early protection at no survival cost. They frame the advice as the best reading of uneven studies, not a settled rule.

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Source: https://europepmc.org/article/MED/PMC13438496