Abstract: Objective  To compare the effects of dual antiplatelet therapy（DAPT） of aspirin combined with ticagreloror clopidogrel on graft patency one year after coronary artery bypass graft surgery(CABG) in patients with chronic kidney disease(CKD). Methods  A total of 77 CABG patients in our department were included in the study. They  were randomly divided into groupA(aspirin+ticagrelor) and group B(aspirin+clopidogrel).There were 35 participants in group A and 42 in group B. Computed tomography angiography (CTA) was performed on them one year after the operation to evaluate the graft patency.Cardiovascular events, bleeding events and other adverse events were also followed up. Results  Totally seven patients were withdrawn in the followup，and 70 patients received CTA.Among them, 32 cases in group A and 38 cases in group B. The patency rate of vein bridge in group A was significantly higher than that in group B (46/51 90.2% vs 42/56 75.0%，P=0.024). And the incidence rate of minor bleeding events in group A was higher than that in group B (P=0.022). Logistic regression analysis revealed that DAPT of aspirin combined with ticagrelor can reduce the risk of vein bridge stenosis(OR=0.193, 95%CI=0.0430.861, P=0.031). Conclusion  DAPT of aspirin combined with ticagrelor after CABG can better maintain the graft patency of CKD patients without additional risk of major bleeding events.

Key words: coronary artery bypass, renal insufficiency, chronic; , platelet aggregation inhibitors, ticagrelor, vascular graft