Comparing High and lOw-dose asPirin With Dual anTIplatelet Therapy for Three Months Using prasUgrel and aSpirin Following Coronary Artery Bypass Grafting. (OPTIMUS-CABG Trial)

Exclusion Criteria

• •1. Cardiogenic shock
• •2. Patients with recent acute coronary syndrome (ACS) (\<12 months)
• •3. Single vessel CABG
• •4. Patients with preoperative atrial fibrillation
• •5. Dialysis
• •6. Thrombocytopenia (platelet count \< 100 000 platelets/uL)
• •7. Anemia (Hemoglobin level \< 10 g/dL)
• •8. Severe liver failure Child-Pugh classification \>4
• •9. Known, active infections with HIV, HBV, HCV, tuberculosis
• •10. Active malignant disease or history of malignancy within the past 5 years
• •11. Indication for DAPT (e.g. recent PCI or ACS or recent stents of peripheral arteries)
• •12. Indication for oral anticoagulant treatment 13 Indications for the use of methotrexate at a dose of 15 mg/week or more
• •14\. Any contraindication for prasugrel or ASA 15. Planned additional cardiac or non-cardiac surgery within 12 months 16. Non-cardiac co-morbidity with life expectancy less than 12 months 17. History of any bleeding complications due to the use of DAPT 18. History of intracranial bleeding 19. History of gastro-intestinal bleeding 20. Pregnancy or breastfeeding 21. Lack of compliance with the use of a highly effective method of birth control 22. Planned coronary endarterectomy 23. Severe impaired renal function (eGFR \<40mL/min/1.73 m2).
• •1. Perioperative cardiogenic shock
• •2. Intraoperative death or death prior randomization
• •3. Myocardial infarction within 12-24 hours following CABG or prior randomization
• •4. Ischemic or hemorrhagic stroke within 12-24 hours following CABG or prior randomization
• •5. Any postoperative complication that may increase patients' risk with DAPT
• •6. Atrial Fibrillation prior randomization
• •7. Gastro-intestinal bleeding prior randomization