AzTrials
AzTrials

Acute Coronary SyndromePhase 4TACSINCT03560310

Ticagrelor and ASA vs. ASA Only After Isolated Coronary Artery Bypass Grafting in Patients With Acute Coronary Syndrome

A Phase 4 study testing Ticagrelor 90mg twice daily and ASA 75-100 mg daily and ASA 75-160 mg daily in people with Acute Coronary Syndrome, run by Vastra Gotaland Region at 22 sites in 5 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

The study is a Randomised Registry-based Clinical Trial (RRCT) to assess whether dual antiplatelet therapy with ticagrelor and ASA compared to ASA alone improves outcome after isolated CABG in patients with acute coronary syndrome. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Acute Coronary Syndrome
What is being tested?
Ticagrelor 90mg twice daily and ASA 75-100 mg daily and ASA 75-160 mg daily
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,201 participants
Where
22 sitesin 5 countries
Study dates
29 Jun 2018to 15 Feb 2035
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent
  • Age ≥18 years
  • Has undergone first time isolated CABG due to an episode of acute coronary syndrome (STEMI, NSTEMI, unstable angina) within 6 weeks before surgery

Who cannot join

  • Previously enrolled in this study (i.e. patient now at repeat encounter)
  • Concomitant surgical procedure other than CABG
  • Anticoagulant treatment after the operation (e.g. warfarin, direct thrombin inhibitors (dabigatran), FXa inhibitors (rivaroxaban, apixaban, heparin, low-molecular weight heparin, fondaparinux)
  • Discharge from the operating hospital to an ICU at another hospital
  • Pregnancy or lactation
  • Known intolerance or contraindication to ticagrelor or ASA
Show all 17Show fewer
  • Any disorder that may interfere with drug absorption
  • Any condition other than coronary artery disease with a life expectancy <12 months
  • Known chronic liver disease, renal disease requiring dialysis or bleeding disorder
  • Atrioventricular block II and III in patients without pacemaker
  • Any other indication for dual antiplatelet therapy, i.e. recent stent implantation
  • Debilitating stroke within 90 days before inclusion
  • Previous intracranial bleeding
  • Treatment with immunosuppressants (e.g. cyclosporine and tacrolimus)
  • Treatment with strong CYP3A4-inhibitors (e.g. ketoconazole, clarithromycin, nefazodone, ritonavir or atazanavir)
  • Any condition that in the opinion of the investigator may interfere with adherence to trial protocol
  • Participation in any other clinical trial evaluating investigational products at the time for enrollment in this study

Trial locations and contacts

22 sites in 5 countries.

22 sites in 5 countries

Sweden8 sites
  • Sahlgrenska University Hospital

    Gothenburg

  • Blekinge Hospital

    Karlskrona

  • Linköping University Hospital

    Linköping

  • Skåne University Hospital

    Lund

  • Örebro University Hospital

    Örebro

  • Karolinska University Hospital

    Stockholm

  • University Hospital of Umeå

    Umeå

  • Uppsala University Hospital

    Uppsala

Other trials in Sweden

Finland5 sites
  • Helsinki University Hospital

    Helsinki

  • Kuopio University Hospital

    Kuopio

  • Oulu University Hospital

    Oulu

  • Tampere University Hospital

    Tampere

  • Turku University Hospital

    Turku

Other trials in Finland

Denmark4 sites
  • Aalborg University Hospital

    Aalborg

  • Aarhus University Hospital

    Aarhus

  • Rigshospitalet

    Copenhagen

  • Odense University Hospital

    Odense

Other trials in Denmark

Norway4 sites
  • St. Olavs hospital, University Hospital

    Bergen

  • Oslo University Hospital

    Oslo

  • University Hospital of North Norway

    Tromsø

  • Haukeland University Hospital

    Trondheim

Other trials in Norway

Iceland1 site
  • Landspítali University Hospital

    Reykjavik

Other trials in Iceland

About this study

Official title: Dual Antiplatelet Therapy With Ticagrelor and Acetylsalicylic Acid (ASA) vs. ASA Only After Isolated Coronary Artery Bypass Grafting in Patient With Acute Coronary Syndrome

The study is a Randomised Registry-based Clinical Trial (RRCT) to assess whether dual antiplatelet therapy with ticagrelor and ASA compared to ASA alone improves outcome after isolated CABG in patients with acute coronary syndrome.

Read the detailed description

The trial is a 1:1 randomized, interventional, multi-national, multi-center, safety/efficacy, parallel assignment, open-label treatment study and will use the RRCT methodology. A RRCT study utilizes existing health care registry platforms to conduct a pragmatic prospective randomized trial.

After the CABG, eligible patients that have consented to the study, will be randomized to either treatment arms. In the intervention arm, patients will be treated with ticagrelor 90 mg twice daily and ASA 75-100 mg daily for 12 months and patients in the control arm will get ASA only (75-160 mg daily according to local guidelines) during the same time period.

The patients will be followed by telephone interviews at 30 days and 365 days after inclusion. After the treatment period patients will be followed during an observation period by collection of outcome data from registries or medical records, 24, 36, 60 and 120 months after inclusion of the patient. No other data but the registry data or data from medical records will be collected.

Being tested
Ticagrelor 90mg twice daily and ASA 75-100 mg daily, ASA 75-160 mg daily
Keywords
Coronary Bypass Grafting, Antiplatelet treatment
Medical subject headings
Acute Coronary Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ticagrelor 90mg twice daily and ASA 75-100 mg dailyDrug

    Assess whether ticagrelor 90 mg twice daily and ASA 75-100 mg daily versus ASA 75-160 mg daily improves outcome after isolated coronary artery bypass grafting in patients with acute coronary syndrome

  • ASA 75-160 mg dailyDrug

    Assess whether ticagrelor 90 mg twice daily and ASA 75-100 mg daily versus ASA 75-160 mg daily improves outcome after isolated coronary artery bypass grafting in patients with acute coronary syndrome

Study groups in NCT03560310
Study groupRoleWhat they receive
Dual antiplatelet therapyExperimentalTicagrelor 90 mg twice daily and ASA 75-100 mg daily for 12 months
Receives: Drug: Ticagrelor 90mg twice daily and ASA 75-100 mg daily
Acetylsalicylic acidActive comparatorASA 75-160 mg daily for 12 months
Receives: Drug: ASA 75-160 mg daily

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time to major adverse cardiovascular events (MACE)

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone improves 12 months outcome defined as time to major adverse cardiovascular events (MACE) after isolated CABG in ACS patients. MACE includes all-cause mortality, myocardial infarction, stroke and new revascularization.

    Measured: within12 months

Secondary outcomes (18)
  1. Time to all cause death

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences all cause death within 12 months after randomization

    Measured: within 12 months

  2. Time to all cause death, myocardial infarction or stroke

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone improves 12 months outcome defined as time to a composite endpoint of all cause death, myocardial infarction or stroke after isolated CABG in ACS patients.

    Measured: within 12 months

  3. Time to cardiovascular death

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences cardiovascular death within 12 months after randomization

    Measured: within 12 months

  4. Time to first myocardial infarction

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences myocardial infarction within 12 months after randomization

    Measured: within 12 months

  5. Time to first stroke

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of stroke within 12 months after randomization

    Measured: within 12 months

  6. Time to new revascularization

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of new revascularization within 12 months after randomization

    Measured: within 12 months

  7. Time to coronary angiography

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of coronary angiography within 12 months after randomization

    Measured: within 12 months

  8. Time to hospitalization for heart failure

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of heart failure within 12 months after randomization

    Measured: within 12 months

  9. Time to cardiovascular hospitalization

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of cardiovascular hospitalization within 12 months after randomization

    Measured: within 12 months

  10. Time to sudden death or aborted cardiac arrest

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of sudden death or aborted cardiac arrest within 12 months after randomization

    Measured: within 12 months

  11. Time to new-onset atrial fibrillation

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of new-onset atrial fibrillation within 12 months after randomization

    Measured: within 12 months

  12. Time to major bleeding defined as bleeding requiring hospitalization

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of major bleeding within 12 months after randomization

    Measured: within 12 months

  13. Time to minor bleeding

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of minor bleeding within 12 months after randomization

    Measured: within 12 months

  14. Time to any bleeding

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of any bleeding within 12 months after randomization

    Measured: within 12 months

  15. Time to dyspnea

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of dyspnea within 12 months after randomization

    Measured: within 12 months

  16. Time to dyspnea causing drug interruption

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of dyspnea causing drug interruption within 12 months after randomization

    Measured: within 12 months

  17. Time to new onset renal failure

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone influences the incidence of new onset renal failure within 12 months after randomization

    Measured: within 12 months

  18. Time to major adverse cardiovascular events (MACE)

    To assess whether dual antiplatelet therapy (DAPT) with ticagrelor and ASA compared to single antiplatelet therapy with ASA alone improves long-term outcome defined as time to major adverse cardiovascular events (MACE) after isolated CABG in ACS patients. MACE includes all-cause mortality, myocardial infarction, stroke and new revascularization.

    Measured: 2, 3, 5 and 10 years after the patient has been included in the study

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Jun 2018
  2. Study start29 Jun 2018
  3. Primary completion13 Mar 2025
  4. Study completion15 Feb 2035 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Parallel treatment arms.
Masking
None (open label)
Enrolment
2,201 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03560310
Sponsor's protocol ID
EudraCT 2017-001499-43
Acronym
TACSI
Status last verified
Aug 2025
First submitted
1 Jun 2018
Last updated
2 Sep 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Jeppsson A, James S, Moller CH, Malm CJ, Dalen M, Vanky F, Modrau IS, Andersen K, Anttila V, Atroshchenko GV, Barbu M, Dreifaldt M, El-Akkawi AI, Friberg O, Gudbjartsson T, Gunn J, Haaverstad R, Halonen J, Hansson EC, Holm J, Husso A, Juvonen T, Jakobsen O, Jideus L, Johannesson E, Jonsson Holmdahl A, Jonsson K, Kolseth SM, Krasniqi L, Makela T, Mennander A, Mohagen Krogstad LE, Rafiq S, Raivio P, Riber L, Tahir A, Thorsen C, Tonnessen T, Wahba A, Zindovic I, Pivodic A, Nielsen SJ, Erlinge D, Alfredsson J, Sartipy U; TACSI Trial Group.; TACSI Trial Group. Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome. N Engl J Med. 2025 Dec 11;393(23):2313-2323. doi: 10.1056/NEJMoa2508026. Epub 2025 Sep 1.

    PubMed 40888737
  • Malm CJ, Alfredsson J, Erlinge D, Gudbjartsson T, Gunn J, James S, Moller CH, Nielsen SJ, Sartipy U, Tonnessen T, Jeppsson A. Dual or single antiplatelet therapy after coronary surgery for acute coronary syndrome (TACSI trial): Rationale and design of an investigator-initiated, prospective, multinational, registry-based randomized clinical trial. Am Heart J. 2023 May;259:1-8. doi: 10.1016/j.ahj.2023.01.011. Epub 2023 Jan 18.

    PubMed 36681173

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Ticagrelor 90mg twice daily and ASA 75-100 mg daily and ASA 75-160 mg daily in people with Acute Coronary Syndrome, run by Vastra Gotaland Region at 22 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 2 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 22 sites in Sweden, Finland, Denmark, Norway, Iceland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time to major adverse cardiovascular events (MACE) (time frame: within12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03560310, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Sep 2025; AzTrials last refreshed its copy on 7 Nov 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in