Clopidogrel and Aspirin Versus Clopidogrel Alone on Graft Patency After Coronary Artery Bypass Grafting

Gao, Changqing; Ren, Chao; Liu, Dong; Li, Libing

doi:10.1016/j.athoracsur.2009.04.024

Cited by 68 publications

(41 citation statements)

References 18 publications

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“…Moreover, post hoc subgroup analyses from multicenter randomized controlled studies have suggested a benefit associated with clopidogrel in patients with a history of CABG or in patients who underwent CABG after trial enrollment. 24,28,29 Most recently, Gao et al 30 reported the results of a nonrandomized trial in which 197 patients were assigned to either clopidogrel 75 mg or clopidogrel 75 mg plus aspirin 100 mg daily after surgery on the basis of a weekly alternating-treatment scheme. Similar to the results of CASCADE, 1-year SVG patency did not differ between the 2 groups (93.5% versus 96.3% for clopidogrel alone versus clopidogrel plus aspirin, Pϭ0.25) as assessed by computed tomography angiography.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to the results of CASCADE, 1-year SVG patency did not differ between the 2 groups (93.5% versus 96.3% for clopidogrel alone versus clopidogrel plus aspirin, Pϭ0.25) as assessed by computed tomography angiography. 30 The CASCADE study has limitations that should be taken into account when interpreting the results. The sample size of the trial was determined on the basis of the only available published values for SVG intimal hyperplasia at 1 year.…”

Section: Discussionmentioning

confidence: 99%

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Aspirin Plus Clopidogrel Versus Aspirin Alone After Coronary Artery Bypass Grafting

et al. 2010

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Background-Clopidogrel inhibits intimal hyperplasia in animal studies and therefore may reduce saphenous vein graft (SVG) intimal hyperplasia after coronary artery bypass grafting. The Clopidogrel After Surgery for Coronary Artery DiseasE (CASCADE) study was undertaken to evaluate whether the addition of clopidogrel to aspirin inhibits SVG disease after coronary artery bypass grafting, as assessed at 1 year by intravascular ultrasound. Methods and Results-In this double-blind phase II trial, 113 patients undergoing coronary artery bypass grafting with SVGs were randomized to receive aspirin 162 mg plus clopidogrel 75 mg daily or aspirin 162 mg plus placebo daily for 1 year. The primary outcome was SVG intimal hyperplasia (mean intimal area) as determined by intravascular ultrasound at 1 year. Secondary outcomes were graft patency, major adverse cardiovascular events, and major bleeding. One-year intravascular ultrasound and coronary angiography were performed in 92 patients (81.4%). At 1 year, SVG intimal area did not differ significantly between the 2 groups (4.1Ϯ2.0 versus 4.5Ϯ2.1 mm 2 , aspirinclopidogrel versus aspirin-placebo, Pϭ0.44). Overall 1-year graft patency was 95.2% in the aspirin-clopidogrel group compared with 95.5% in the aspirin-placebo group (Pϭ0.90), and SVG patency was 94.3% in the aspirin-clopidogrel group versus 93.2% in the aspirin-placebo group (Pϭ0.69). Freedom from major adverse cardiovascular events at 1 year was 92.9Ϯ3.4% in the aspirin-clopidogrel group and 91.1Ϯ3.8% in the aspirin-placebo group (Pϭ0.76). The incidence of major bleeding at 1 year was similar for the 2 groups (1.8% versus 0%, aspirin-clopidogrel versus aspirin-placebo, Pϭ0.50). Conclusions-Compared with aspirin monotherapy, the combination of aspirin plus clopidogrel did not significantly reduce the process of SVG intimal hyperplasia 1 year after coronary artery bypass grafting. Clinical Trial Registration-URL: http://www.clinicaltrials.gov.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Aspirin Plus Clopidogrel Versus Aspirin Alone After Coronary Artery Bypass Grafting

et al. 2010

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“…Despite the fact that it has been postulated that there is a synergistic effect on platelet inhibition exerted by the combination of clopidogrel and aspirin, similar data have already been reported. 13,29,30, 32 Leong et al, in a prospective study of 919 isolated CABG patients, reported no differences in postoperative bleeding and blood transfusions between subjects taking clopidogrel and aspirin, and those taking clopidogrel alone. 13 And no differences were detected with regard to other outcomes and hospital resource utilization.…”

Section: Discussionmentioning

confidence: 99%

“…13 Gao et al also found no significant differences for surgical blood loss and transfusion volume in patients treated with clopidogrel plus aspirin compared to those taking clopidogrel alone. 32 …”

Section: Discussionmentioning

confidence: 99%

Optimal Timing of Discontinuation of Clopidogrel and Risk of Blood Transfusion After Coronary Surgery - Propensity Score Analysis -

Mariscalco

Bruno

Cottini

et al. 2011

Circ J

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“…In the first study published in 2009, Gao and colleagues 37 performed a nonrandomized trial involving 197 CABG patients, 37% of whom underwent off-pump surgery. Patients were assigned postoperatively to either isolated clopidogrel 75 mg daily (n=102) or clopidogrel 75 mg plus aspirin 100 mg daily (n=95) on the basis of a weekly alternating treatment scheme.…”

Section: P2y 12 Receptor Inhibitorsmentioning

confidence: 99%

Secondary Prevention After Coronary Artery Bypass Graft Surgery

Kulik¹,

Ruel²,

Jneid³

et al. 2015

Circulation

319

177

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Clopidogrel and Aspirin Versus Clopidogrel Alone on Graft Patency After Coronary Artery Bypass Grafting

Cited by 68 publications

References 18 publications

Aspirin Plus Clopidogrel Versus Aspirin Alone After Coronary Artery Bypass Grafting

Aspirin Plus Clopidogrel Versus Aspirin Alone After Coronary Artery Bypass Grafting

Optimal Timing of Discontinuation of Clopidogrel and Risk of Blood Transfusion After Coronary Surgery - Propensity Score Analysis -

Secondary Prevention After Coronary Artery Bypass Graft Surgery

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