Brilinta Bleeding Risks Increased for Patients Undergoing Coronary Artery Bypass Graft Surgery: Study

Side effects of Brilinta tripled the risk of significant bleeding events following coronary artery bypass, although the blood thinner did decrease the risk of vein graft failure

While Brilinta decreases the risk of vein graft failure following coronary artery bypass graft surgery, the findings of a new study also warns side effects of the blood thinner may increase the risk of serious bleeding events for those patients.

In a report published this month in the Journal of the American Medical Association (JAMA), researchers from Canada, Europe and the U.S. indicate that Brilinta dual antiplatelet therapy (DAPT) is nearly three times as likely to cause significant bleeding events than aspirin, when given as a blood thinner following coronary artery bypass graft surgery.

Brilinta (ticagrelor) is prescribed to reduce the risk of cardiovascular death, heart attacks and strokes in patients with acute coronary syndrome (ACS), or by those with history of heart attacks. Brilinta is also commonly used to reduce the rate of stent thrombosis in patients who have received stents for treatment of ACS.

In this new study, researchers conducted a meta-analysis of four randomized clinical trials, involving 1,316 patients who underwent 1,668 saphenous vein graft procedures. They used data from the MEDLINE, Embase, and Cochrane Library databases from their inceptions to June 1, 2022. The researchers looked at the effectiveness of Brilinta alone, Brilinta DAPT or aspirin.

According to the findings, Brilinta DAPR treatment was only half as likely to result in vein graft failure. However, it was associated with nearly three times the risk of serious bleeding events. There was little difference between Brilinta monotherapy and the use of aspirin alone.

The findings are similar to those of a stroke study published in 2019, which indicated taking Brillinta with aspirin did not reduce the risk of stroke, but instead increased the risk of serious bleeding. Similar results were published in the New England Journal of Medicine in 2020. Another study published in 2016 indicated patients taking Brillinta before heart surgery faced an increased risk of up to 20% for bleeding events.

“Among patients undergoing coronary artery bypass graft surgery, adding ticagrelor to aspirin was associated with a significantly decreased risk of vein graft failure,” the researchers concluded. “However, this was accompanied by a significantly increased risk of clinically important bleeding.”