Prevention of Coronary Vein Graft Occlusion: Low-Dose Acetylsalicylic Acid Versus Coumarin (Asaac - Study)

Abstract

Thrombotic graft occlusion occurs within a few hours after surgery, suggesting a benefit of preoperative start of antiplatelet treatment. We investigated the effectivity and risk of preoperatively started treatment with 100 mg/day acetyl salicylic acid (ASA) compared to anticoagu1 ation started 6 hours postoperatively (heparin followed by coumarin (AC)). The prospective randomized trial yielded the following results:Preoperative low dose ASA increased chest-tube blood loss. This indicates effective antiplatelet activity of low dose ASA. Perioperative platelet consumption and coagulation factors activity was not altered.It is concluded, that graft patency rates are similar with postoperative anticoagu1 ation or antiplatelet treatment with low dose acetylsalicylic acid.