Aortocoronary bypass graft surgery with the use of arterial and/or venous grafts is well-established method of cardiac revascularization. While the long-term patency of arterial grafts is outstanding, venous grafts are burdened with quite a high rate of occlusions, potentially posing a risk of myocardial infarction, necessity of revascularization and death to the patient.
Acetylosalysic acid is indicated in all patients with ischemic heart disease (in the absence of contraindications). Its early administration is important in order to prevent venous graft occlusion as well as to affect morbidity and mortality in the patients after the surgical revascularization of myocardium.
Whether dual antiplatelet therapy by adding clopidogrel or ticagrelor or prasugrel to acetylosalysic acid may further improve outcomes of these patients remains unresolved. The results of the clinical trials and current opinion are presented in this review article.
The existing knowledge on the new P2Y12 receptor antagonists (ticagrelor and prasugrel) is mentioned as well.