The risk of bleeding with antithrombotic therapy may outweigh the threat of recurrent ischaemic events in many survivors of acute coronary syndrome who undergo CABG, an Australian study suggests.

The modelling shows, however, that most post-acute coronary syndrome (ACS) patients will benefit from extended antithrombotic therapy, with the 6-18 months risk of ischaemic events exceeding that of major bleeds.

The researchers, led by interventional cardiologist Professor David Brieger at Sydney’s Concord Hospital, said that, if validated in other cohorts, their study findings may contribute to development of a decision-making tool for balancing protection against events with the risk of bleeds.

The team used data from 5900 older adults who were alive six months following their ACS to determine the risk of both ischaemic and bleeding outcomes and to also identify those who would benefit from a longer period of dual antiplatelet therapy (DAPT).