Low-dose aspirin versus anticoagulants for prevention of coronary graft occlusion

Weber, Michael A.; Hasford, Joerg; Taillens, C; Zitzmann, Alexander; Hahalis, Georg; Seggewiss, Herbert; Langbehn, Axel F.; Fassbender, D; Buchwalsky, R; Theisen, K.; Hauf, E

doi:10.1016/0002-9149(90)90535-9

Cited by 26 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of 32 publications identified for review, none were excluded for administering aspirin in doses of less than 50 mg, 14 were excluded for administering aspirin in dosages above 325 mg (ranging from 650 mg to 1200 mg a day),14 – 26 seven trials did not have an aspirin only arm,27 – 33 and two did not use placebo control 34 35. Four further publications were excluded because they were repeat publications with the same data 36 – 39.…”

Section: Resultsmentioning

confidence: 99%

Indirect comparison meta-analysis of aspirin therapy after coronary surgery

Lim

Ali²,

Ali³

et al. 2003

BMJ

View full text Add to dashboard Cite

Objectives To evaluate the efficacy of low and medium dose aspirin therapy after coronary surgery by using an indirect comparison meta-analysis. Data sources Systematic literature search of Medline, Embase, Cochrane controlled trials register, and trial register sites on the internet. Study selection Outcome was evaluated by angiography and reported as graft occlusion and rate of events in patients. Trials that did not include aspirin as the sole therapy or did not have a placebo control arm were excluded. Articles were assessed for eligibility and quality and grouped according to dosage. The estimated difference in effect of low and medium dose aspirin on graft occlusion was obtained by combining the estimated log relative risks of low dose with placebo and medium dose with placebo. Results For graft occlusion, the medium dose trials yielded a relative risk reduction of 45% compared with 26% for the low dose trials. The greater effect in the medium dose trials is summarised by a relative risk ratio of 0.74 (95% confidence interval 0.52 to 1.06; P = 0.10) for graft occlusion and 0.81 (0.57 to 1.16; P = 0.25) for events in patients. Conclusions Medium dose aspirin may more successfully reduce graft occlusion than low dose regimens within the first year after coronary surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

Indirect comparison meta-analysis of aspirin therapy after coronary surgery

Lim

Ali²,

Ali³

et al. 2003

BMJ

View full text Add to dashboard Cite

show abstract

“…Cyclic AMP (cAMP) was measured by preincubating platelets with saline (control), agents, or forskolin (Colforsin) at 37ЊC for 5 min followed by extraction with Ba(OH) 2 and ZnSO 4 . cAMP in the extracts was converted into the etheno-cAMP derivative and the levels were measured by HPLC using a fluorescence detector (19).…”

Section: Methodsmentioning

confidence: 99%

“…Various antiplatelet agents have been studied for many years as potential targets for beneficial clinical inventions with respect to the inhibition of thrombus formation. Some agents such as aspirin and dipyridamole have come into use as prophylactic antithrombotic agents, and others have been the subjects of clinical investigations (1)(2)(3).…”

mentioning

confidence: 99%

P ¹ , P ⁴ -Dithio- P ² , P ³ -monochloromethylene diadenosine 5′,5‴- P ¹ , P ⁴ -tetraphosphate: A novel antiplatelet agent

Chan

Gallo

Kim

et al. 1997

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

We have previously demonstrated in a series of searches for antithrombotic agents that diadenosine 5,5ٟ-P 1 , P 4 -tetraphosphate (AppppA) and its analogues are competitive inhibitors of ADP-induced platelet aggregation. Among various analogues, the P 2 , P When tested for their inhibitory effects on platelet aggregation by ADP, the most promising agent among them was Ap s pCHClpp s A. Both molecular and functional integrity of this compound proved to be stable in blood at 37؇C for at least 3 h. It also showed an excellent heat stability. This agent inhibits a number of aspects of ADP-induced platelet activation-e.g., release reaction, cytoplasmic calcium mobilization, thromboxane production, fibrinogen binding sites, and platelet factor 3 activity. Moreover, platelet aggregation induced by agonists other than ADP-e.g., arachidonic acid, collagen, and epinephrine-was inhibited partially by Ap s pCHClpp s A. It is concluded that (i) Ap s pCHClpp s A is a promising antiplatelet agent; (ii) it is resistant to blood phosphodiesterases and stable to heat treatment; (iii) platelet aggregation induced by collagen, epinephrine, or arachidonic acid is also inhibited in part by this agent; and (iv) specificity of the inhibitory effects is presented by unmodified adenosine moieties of the agent. Resistance to phosphodiesterases raises the possibility of oral administration.

show abstract

“…The efficacy of aspirin in the prevention of death and myocardial infarction in patients with unstable angina has been well documented, as has the efficacy of aspirin in maintaining venous graft patency when initiated at the time of surgery. [5][6][7][8][9][10][11][12] However, long-term benefits to maintain graft patency are less well documented. Warfarin used alone can prevent recurrence of unstable angina 13 but has not been shown to be more effective than aspirin in maintaining graft patency.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Aspirin prevents graft closure during the first year after surgery, [5][6][7][8][9][10][11][12] but its long-term benefit in this specific setting has not been documented. Warfarin had been evaluated in unstable angina, 13 but no studies have addressed the specific population of patients with unstable coronary syndromes without ST elevation developing late after CABG.…”

mentioning

confidence: 99%

Aspirin, Warfarin, or the Combination for Secondary Prevention of Coronary Events in Patients With Acute Coronary Syndromes and Prior Coronary Artery Bypass Surgery

et al. 2001

View full text Add to dashboard Cite

Background —Patients with a non–ST-elevation acute coronary syndrome and prior CABG are at high risk of a recurrent ischemic event despite aspirin therapy. This trial investigated the potential benefit of secondary prevention with warfarin. Methods and Results —In a double-blind randomized trial, 135 patients with unstable angina or non–ST-segment elevation myocardial infarction, with prior CABG, and who were poor candidates for a revascularization procedure received therapy with aspirin and placebo+warfarin, warfarin and placebo+aspirin, or aspirin and warfarin for 12 months. Warfarin was titrated to an international normalized ratio of 2.0 to 2.5. The primary end point (death or myocardial infarction or unstable angina requiring hospitalization 1 year after randomization) occurred in 14.6% of the patients in the warfarin-alone group, in 11.5% of patients in the aspirin-alone group, and in 11.3% of patients randomized to the combination therapy ( P =0.76). Subgroup analyses by risk features provided no indications that warfarin alone or in combination with aspirin could be of benefit over aspirin alone. Bleeding was more frequent in the 2 groups of patients administered warfarin. Conclusions —Moderate-intensity oral anticoagulation alone or combined with low-dose aspirin does not appear to be superior to low-dose aspirin in the prevention of recurrent ischemic events in patients with non–ST-elevation acute coronary syndromes and previous CABG.

show abstract

Low-dose aspirin versus anticoagulants for prevention of coronary graft occlusion

Cited by 26 publications

References 25 publications

Indirect comparison meta-analysis of aspirin therapy after coronary surgery

Indirect comparison meta-analysis of aspirin therapy after coronary surgery

P ¹ , P ⁴ -Dithio- P ² , P ³ -monochloromethylene diadenosine 5′,5‴- P ¹ , P ⁴ -tetraphosphate: A novel antiplatelet agent

Aspirin, Warfarin, or the Combination for Secondary Prevention of Coronary Events in Patients With Acute Coronary Syndromes and Prior Coronary Artery Bypass Surgery

Contact Info

Product

Resources

About

Low-dose aspirin versus anticoagulants for prevention of coronary graft occlusion

Cited by 26 publications

References 25 publications

Indirect comparison meta-analysis of aspirin therapy after coronary surgery

Indirect comparison meta-analysis of aspirin therapy after coronary surgery

P 1 , P 4 -Dithio- P 2 , P 3 -monochloromethylene diadenosine 5′,5‴- P 1 , P 4 -tetraphosphate: A novel antiplatelet agent

Aspirin, Warfarin, or the Combination for Secondary Prevention of Coronary Events in Patients With Acute Coronary Syndromes and Prior Coronary Artery Bypass Surgery

Contact Info

Product

Resources

About

P ¹ , P ⁴ -Dithio- P ² , P ³ -monochloromethylene diadenosine 5′,5‴- P ¹ , P ⁴ -tetraphosphate: A novel antiplatelet agent