Heart surgery for patients with acute coronary syndrome just two to three days after ceasing ticagrelor therapy causes no more severe bleeds than a longer wait, a landmark trial shows.

The RAPID CABG trial is the first randomised controlled study comparing early coronary artery bypass graft (CABG) surgery with surgery at five to seven days after stopping the blood thinner, which is the recommended delay in many guidelines, including Australia’s.

The Canadian study, presented at the American Heart Association Scientific Sessions 2021 virtual meeting, found that shortening the interval had non-inferior outcomes.

“We discovered no significant increase in bleeding when people had bypass surgery after 2-3 days of discontinuing ticagrelor,” said lead study author Professor Derek So, a cardiologist at the University of Ottawa Heart Institute in Ottawa, Canada.