{
  "abstract": "Objectives The effect of early antiplatelet therapy on 30-day mortality after coronary artery bypass grafting (CABG) remains uncertain. This study aimed to evaluate the association between early antiplatelet therapy initiation and clinical outcomes in post-CABG patients.Design A retrospective target trial emulation.Setting Single academic medical centre in Boston, Massachusetts, USA.Participants We included adult patients who underwent CABG and were admitted to the intensive care unit at Beth Israel Deaconess Medical Center between 2008 and 2022.Methods Patients were classified into the treatment group if they initiated antiplatelet therapy within 24 hours postoperatively; otherwise, they were assigned to the control group. To address immortal-time bias for the primary outcome of 30-day mortality, we used clone-censor-weighting. For the exploratory outcome of 30-day acute kidney injury (AKI) incidence, we employed inverse probability of treatment weighting to balance baseline covariates.Results The analysis for 30-day mortality included 6887 patients. The mortality was 2.35% in the control group versus 1.44% in the treatment group, yielding an absolute risk difference of 0.90% (control group minus treatment group, 95% CI 0.09% to 1.72%). The difference in restricted mean time lost was 0.19 days (control group minus treatment group, 95% CI 0.03 to 0.36). For AKI incidence, 5543 patients were analysed. The incidence was 78.61% in the control group and 69.13% in the treatment group, with an absolute difference of 9.48% (control group minus treatment group, 95% CI 6.40% to 12.50%; p<0.001).Conclusions In this target trial emulation, early antiplatelet therapy initiated within 24 hours after CABG was associated with lower 30-day mortality and a reduced incidence of postoperative AKI. These findings warrant confirmation in prospective randomised controlled trials.",
  "authors": [
    {
      "affiliations": [
        "Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou, Jiangsu, China"
      ],
      "name": "Ying Jiang"
    },
    {
      "affiliations": [
        "Xuzhou Central Hospital, Xuzhou, China"
      ],
      "name": "Huafeng Ding"
    },
    {
      "affiliations": [
        "Xuzhou Central Hospital, Xuzhou, China"
      ],
      "name": "Jing Su"
    },
    {
      "affiliations": [
        "Xuzhou Central Hospital, Xuzhou, China"
      ],
      "name": "Xiangquan Li"
    }
  ],
  "title": "Effect of early antiplatelet therapy on 30-day mortality after coronary artery bypass grafting: a retrospective target trial emulation using the MIMIC-IV database",
  "uid": "a1c43594-71c2-5da8-b40a-2a54aa2f94d9"
}