Considerations about the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial

A perspective on the one-year results of the Aspirin and Tranexemic Acid for Coronary Artery Surgery trial

“…The reason to suspect that the study design is sound is that there is evidence that an antiplatelet effect of ASA can be achieved within 2 hours. However, in their commentary on the 30-day results of ATACAS, the concerns raised by Di Franco and colleagues 4 are valid and apply to the 1-year results even more so than to that of the 30-day results. They cite a study reexamining the pharmacodynamics and pharmacokinetics of ASA 5 that suggests it takes longer than 2 hours to achieve peak plasma concentrations after a single dose of ASA or to achieve nadir thromboxane B 2 levels (an indirect biomarker of drug action).…”