New Research Challenges Standard Post-Surgery Heart Treatment
Gothenburg, Sweden – A new study published online September 1, 2025, in The New England Journal of Medicine suggests that combining two blood-thinning medications after coronary artery surgery for acute coronary syndrome offers no benefit over aspirin alone, and may even increase the risk of serious bleeding complications. The findings could lead to a notable shift in post-operative cardiac care protocols.
Currently, many patients undergoing coronary artery surgery are prescribed dual antiplatelet therapy – typically aspirin and ticagrelor – to prevent blood clots. However, this research indicates that for this specific patient population, the added protection doesn’t outweigh the potential dangers. “The results are vital as thay probably mean that we should change our treatment of patients after coronary artery surgery,” explains Ulrik Sartipy, adjunct professor at the Department of Molecular Medicine and Surgery, Karolinska Institutet, and chief physician in thoracic surgery at Karolinska University Hospital, and the study’s last author. “The currently recommended treatment with double thrombocyte inhibition gives no profits – on the contrary, the risk of serious bleeding complications compared to treatment with only acetylsalicylic acid increases.”
The study, titled “ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome” (A.Jeppsson, St. James CH Moller. Friberg,T. Gunn, J. Gunn, R. Haravertine, J. Haloen, EC Hansson, J. Holm,A. Husso, T. Juvonen, Ø. Jacobsen, L. Jideus, E.Jonasson, A. Jonsson Holmdahl, K. Josson, SM Kolleth, L.Krasniqi, T. Woods, A. Menander, L.-E. Mohagen Krogstad, S.), was funded by the Swedish Research Council, the Heart Lungfonden, and the Swedish state through the ALF agreement. The research is based on a press release originating from the University of Gothenburg.
The findings are particularly relevant given the high number of individuals undergoing coronary artery surgery globally each year, and the potential for significant morbidity associated with post-operative bleeding. Further inquiry and clinical guideline updates will be necessary to determine the optimal post-operative antiplatelet strategy for patients with acute coronary syndrome.
