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Turkish Society of Cardiology
Young Cardiologists
President
Dr. Muzaffer Değertekin
Coordinator for the
Board of Directors
Dr. Ertuğrul Okuyan
Coordinator for the
Board of Directors
Dr. Can Yücel Karabay
Members
Dr. Adem Aktan
Dr. Gülşah Aktüre
Dr. Bayram Arslan
Dr. İnanç Artaç
Dr. Ahmet Oğuz Aslan
Dr. Görkem Ayhan
Dr. Ahmet Anıl Başkurt
Dr. Özkan Bekler
Dr. Oğuzhan Birdal
Dr. Yusuf Bozkurt Şahin
Dr. Serkan Bulgurluoğlu
Dr. Ümit Bulut
Dr. Veysi Can
Dr. Mustafa Candemir
Dr. Murat Çap
Dr. Göksel Çinier
Dr. Ali Çoner
Dr. Yusuf Demir
Dr. Ömer Furkan Demir
Dr. Murat Demirci
Dr. Ayşe İrem Demirtola Mammadli
Dr. Süleyman Çağan Efe
Dr. Mehmet Akif Erdöl
Dr. Kubilay Erselcan
Dr. Kerim Esenboğa
Dr. Duygu Genç
Dr. Kemal Göçer
Dr. Elif Güçlü
Dr. Arda Güler
Dr. Duygu İnan
Dr. Hasan Burak İşleyen
Dr. Muzaffer Kahyaoğlu
Dr. Sedat Kalkan
Dr. Yücel Kanal
Dr. Özkan Karaca
Dr. Ahmet Karaduman
Dr. Mustafa Karanfil
Dr. Ayhan Kol
Dr. Fatma Köksal
Dr. Mevlüt Serdar Kuyumcu
Dr. Yunus Emre Özbebek
Dr. Ahmet Özderya
Dr. Yasin Özen
Dr. Ayşenur Özkaya İbiş
Dr. Çağlar Özmen
Dr. Selvi Öztaş
Dr. Hasan Sarı
Dr. Serkan Sivri
Dr. Ali Uğur Soysal
Dr. Hüseyin Tezcan
Dr. Nazlı Turan
Dr. Berat Uğuz
Dr. Örsan Deniz Urgun
Dr. İdris Yakut
Dr. Mustafa Yenerçağ
Dr. Mehmet Fatih Yılmaz
Dr. Yakup Yiğit
Dr. Mehmet Murat Yiğitbaşı
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Dual or single antiplatelet therapy after coronary surgery for acute coronary syndrome (TACSI trial)Türk Kardiyoloji Derneği Genç Kardiyologlar Bülteni - Dual or single antiplatelet therapy after coronary surgery for acute coronary syndrome (TACSI trial) (Dr. Şeyma Zeynep Atıcı)Study Title: Dual or single antiplatelet therapy after coronary surgery for acute coronary syndrome (TACSI trial)
Conference: ESC Congress 2025
Prepared by: Dr. Şeyma Zeynep Atıcı
Introduction
The TACSI trial aims to assess the superiority of a 1-year treatment with dual antiplatelet therapy (DAPT) consisting of acetylsalicylic acid (ASA) and ticagrelor, compared to ASA alone, in patients with acute coronary syndrome (ACS) undergoing isolated coronary artery bypass graft (CABG) surgery.
Objective
DAPT is strongly recommended in guidelines for the first 12 months after CABG in ACS patients (Class 1). However, due to the lack of prospective, randomized studies demonstrating the superiority of DAPT, adherence to guidelines has been reported to be low. Therefore, the objective of the TACSI trial is to evaluate the 12-month (time to major adverse cardiovascular events [MACE]) outcomes of DAPT compared to single antiplatelet therapy (SAPT) with ASA.
Methods
A total of 2200 participants were included in this randomized clinical trial conducted at 22 Scandinavian cardiothoracic surgery centers. The main exclusion criteria included: concomitant surgical procedures, oral anticoagulant therapy, another indication for DAPT (e.g., new stent), dialysis-dependent renal disease, severe liver disease, and coagulopathy.
The primary efficacy endpoint was the time to MACE, which included all-cause mortality, myocardial infarction, stroke, or the need for new coronary revascularization within 12 months. The primary safety endpoint was major bleeding.
Results
In the TACSI study, no significant difference was observed between DAPT and ASA monotherapy in terms of MACE, but the risk of major bleeding was increased in the first year after surgery.
Conclusion
The primary endpoint event occurred in 4.8% (53 patients) of the ticagrelor plus aspirin group, compared to 4.6% (50 patients) in the aspirin-only group. Net adverse clinical events occurred in 9% of patients assigned to ticagrelor plus aspirin, compared to 6% of those assigned to aspirin alone. Major bleeding was higher in the ticagrelor plus aspirin group (5%) compared to the aspirin-only group (2%).
Discussion
Current guidelines strongly recommend DAPT after ACS; however, large, randomized studies comparing DAPT to SAPT in CABG patients are still lacking. Although the TACSI trial did not demonstrate the superiority of DAPT, further long-term studies are needed.
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