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\begin{document}

\title{Ticagrelor Use and Practice Pattern among Canadian Cardiac Surgeons}



\author[1]{Ahmed Makhdoum}%
\author[1]{Subodh Verma}%
\author[1]{Bobby Yanagawa }%
\author[1]{Nitish Dhingra }%
\author[2]{Rachel Eikelboom}%
\author[3]{Thin Vo}%
\author[4]{Joel Bierer}%
\author[5]{Jessica Luc}%
\author[2]{Olina Dagher}%
\author[6]{Andreanne Cartier}%
\author[7]{olivier vaillancourt}%
\author[8]{Kier Forgie}%
\author[1]{Gianluigi Bisleri}%
\author[9]{Terrence Yau}%
\affil[1]{University of Toronto}%
\affil[2]{Affiliation not available}%
\affil[3]{University of Ottawa}%
\affil[4]{Dalhousie University}%
\affil[5]{The University of British Columbia}%
\affil[6]{Laval University}%
\affil[7]{McGill University}%
\affil[8]{University of Alberta}%
\affil[9]{Toronto General Hospital}%


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  \date{May 19, 2024}


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\begin{abstract}
Background and Aim: The P2Y12 platelet receptor inhibitor ticagrelor is
widely used in patients following acute coronary syndromes or in those
who have received coronary stents. Bentracimab is a monoclonal
antibody-based reversal agent that is being formally evaluated in a
Phase 3 clinical trial. Here, we probe the knowledge, attitudes, and
practice patterns of cardiac surgeons regarding their perioperative
management of ticagrelor and potential application of a ticagrelor
reversal agent. Methods: A questionnaire was developed by a working
group of cardiac surgeons to inquire into participants' practices and
beliefs regarding ticagrelor and disseminated to practicing Canadian
cardiac surgeons. Results: A total of 70 Canadian cardiac surgeons
participated. Bleeding risk was identified as the most significant
consideration when surgically revascularizing ticagrelor-treated
patients (90\%). There is variability in the duration of withholding
ticagrelor prior to coronary artery bypass graft procedure in a stable
patient; 44.3\% wait 3 days and 32.9\% wait 4 days or longer. Currently,
14.3\% of cardiac surgeons prophylactically give platelet transfusions
and/or fresh frozen plasma intraoperatively following protamine infusion
in patients who have recently received ticagrelor. Interestingly, 47.1\%
of surveyed surgeons were aware of a reversal agent for ticagrelor,
91.4\% of cardiac surgeons would consider utilizing a ticagrelor
reversal agent if available, and 51.4\% acknowledged that the
introduction of such an agent would be a major advance in clinical
practice. Conclusions: The present survey identified ticagrelor-related
bleeding as a major concern for cardiac surgeons. Surgeons recognized
the significant unmet need that a ticagrelor reversal agent would
address.%
\end{abstract}%



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\verb`Ticagrelor Figure 2.pptx`  available at \url{https://authorea.com/users/384085/articles/516548-ticagrelor-use-and-practice-pattern-among-canadian-cardiac-surgeons}

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\verb`Ticagrelor Figure 3.pptx`  available at \url{https://authorea.com/users/384085/articles/516548-ticagrelor-use-and-practice-pattern-among-canadian-cardiac-surgeons}

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\verb`Ticagrelor Figure 4.pptx`  available at \url{https://authorea.com/users/384085/articles/516548-ticagrelor-use-and-practice-pattern-among-canadian-cardiac-surgeons}

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