Aspirin plus clopidogrel for optimal platelet inhibition following off-pump coronary artery bypass surgery: results from the CRYSSA (prevention of Coronary arteRY bypaSS occlusion After off-pump procedures) randomised study

Mannacio, Vito; Tommaso, Luigi Di; Antignan, Anita; Amicis, Vincenzo De; Vosa, Carlo

doi:10.1136/heartjnl-2012-302449

Cited by 122 publications

(130 citation statements)

References 32 publications

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“…In a study following CE with OPCABG, Erylimaz et al shows no mortality at one-year follow-up 19 .Naseri et al who compared both on pump and off pump CABG with CE, described a mortality of 2.2% in a series of 44 patients 18 . The number of multiple endarterectomies in our review was 16.5%, which is higher in compared to other study 21 24 . Despite the advancement of medical science, the morbidity and mortality following CE with CABG is more prominent than with CABG alone 26 .…”

Section: Discussioncontrasting

confidence: 38%

Outcome of CABG with or without Coronary Endarterectomy in Bangladesh: A Retrospective Cohort Study

et al. 2018

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Abstract:Objective: In this review, we assess the outcome of surgical revascularization technique, coronary artery bypass grafting (CABG) with or without coronary endarterectomy (CE) for patients with diffuse coronary artery disease in a single surgeon's practice. Results: Of 2189 patients, 1000 patients required coronary endarterectomy in addition to OPCABG. Initially, there was a higher mortality rate and incidence of postoperative blood transfusion in the group of patients who had CE in addition to CABG, with no significant difference in other outcomes. But postoperative use of Heparin, Warfarin and Double antiplatelet agent was associated with decreased mortality significantly in our study. In comparison to other group, the patients in the combined CE with CABG group had a higher incidence of male sex, past MI, and poor left ventricular function. However,emergency CABG, renal impairment, poor left ventricular function, and also peripheral vascular disease were associated with higher mortality in both group of the patients; CE was not a predictor of postoperative mortality. MethodsConclusions: Total surgical revascularization is attainable and accomplishes, when Coronary endarterectomy is performed in addition to Off-pump coronary artery bypass graft in patients when there is no other choice for satisfactory revascularization.

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Section: Discussioncontrasting

confidence: 38%

Outcome of CABG with or without Coronary Endarterectomy in Bangladesh: A Retrospective Cohort Study

et al. 2018

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“…Although previous studies have examined the effect of DAPT on graft patency and clinical outcomes after CABG, [6][7][8][9] none to our knowledge has addressed its effects on progression of native coronary artery disease (CAD). The issue is relevant because CAD progression occurs more frequently than graft failure after CABG and can lead to myocardial infarction, revascularization, and death.…”

mentioning

confidence: 99%

Impact of Clopidogrel Plus Aspirin Versus Aspirin Alone on the Progression of Native Coronary Artery Disease After Bypass Surgery

et al. 2014

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Background-The effects of dual antiplatelet therapy with aspirin and clopidogrel on the progression of native coronary artery disease after coronary artery bypass grafting are unknown. Methods and Results-In the Clopidogrel After Surgery for Coronary Artery DiseasE (CASCADE) trial, a total of 113 patients were randomized to receive aspirin plus clopidogrel or aspirin plus placebo for 1 year after coronary artery bypass grafting. In this secondary analysis, the 92 patients who underwent preoperative and 1-year postoperative angiograms at 2 centers had each of their coronary stenoses graded serially by using 6 thresholds (grade 0 . We compared the incidence and degree of evolving coronary artery disease between the 2 treatment groups. A total of 543 preoperative stenoses and occlusions were quantified and followed. At 1-year postoperatively, there were 103 evolving (94 worsened, 9 improved) and 22 new lesions. The right coronary artery territory and sites proximal to a graft were more commonly associated with worsening coronary artery disease (P≤0.02). There were no differences in clinical events between treatment groups, and the proportion of patients with evolving or new lesions was also similar (70% versus 74%, aspirin-clopidogrel versus aspirin-placebo, respectively; P=0.8). However, in evolving or new lesions, the mean grade change (1.1±1.0 versus 1.6±1.1, respectively; P=0.01) and the proportion of new occlusions (7% versus 22%; P=0.02) were lower in the aspirin-clopidogrel group. Conclusions-The addition of clopidogrel to aspirin correlates with less worsening of native coronary artery disease 1 year after coronary artery bypass grafting. These findings may help guide post-coronary artery bypass grafting antiplatelet therapy. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00228423.[(Circulation. 2014;130[suppl 1]:S12-S18.)

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“…Investigator in the prevention of Coronary Artery Bypass Occlusion After CABG (CRYSSA trial) reported an alarming correlation between resistance to APT and graft occlusion (RR, 3.6; 95% CI, 2.5-6.9; p<0.001) 34 . 16 .…”

Section: Review Of Literaturementioning

confidence: 99%

Impact of aspirin resistance on outcomes among patients following coronary artery bypass grafting: exploratory analysis from randomized controlled trial (NCT01159639)

Petričević

Kopjar

Gašparović

et al. 2014

J Thromb Thrombolysis

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Aspirin plus clopidogrel for optimal platelet inhibition following off-pump coronary artery bypass surgery: results from the CRYSSA (prevention of Coronary arteRY bypaSS occlusion After off-pump procedures) randomised study

Abstract: Combined clopidogrel and aspirin overcome single drug resistances, are safe for bleeding and improve venous graft patency.

Cited by 122 publications

References 32 publications

Outcome of CABG with or without Coronary Endarterectomy in Bangladesh: A Retrospective Cohort Study

Outcome of CABG with or without Coronary Endarterectomy in Bangladesh: A Retrospective Cohort Study

Impact of Clopidogrel Plus Aspirin Versus Aspirin Alone on the Progression of Native Coronary Artery Disease After Bypass Surgery

Impact of aspirin resistance on outcomes among patients following coronary artery bypass grafting: exploratory analysis from randomized controlled trial (NCT01159639)

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