Benefits of antithrombotic therapy after infrainguinal bypass grafting: a meta-analysis

The American Journal of Medicine
Tracie C CollinsRebecca J Beyth

Abstract

We performed a meta-analysis to ascertain the benefits of antithrombotic therapy for maintaining the patency of vascular grafts following lower extremity bypass operations. We identified articles using MEDLINE and hand searches of relevant journals for randomized clinical trials that compared the use of antithrombotic therapy with control or placebo therapy. Random-effects (DerSimonian and Laird) analyses were used to determine the risk of graft occlusion following lower extremity bypass operations. We also assessed the odds of secondary outcomes, such as myocardial infarction, cerebrovascular accident, all-cause mortality, and bleeding. Sixteen articles met the inclusion criteria of a randomized trial of antithrombotic therapy for the patency of vascular grafts; six were excluded because the analyses involved repeat surgeries or lacked a control group. Of the 10 studies included in the final analysis, seven compared antiplatelet agents with placebo or control, and three compared anticoagulant agents with placebo or control. The 10 studies were homogeneous in spite of differing durations of follow-up. The odds of graft occlusion in the treated group was half that in the placebo or control group. The odds ratio was 0.46 (95% con...Continue Reading

References

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Jun 26, 2003·Archives of Internal Medicine·Tracie C CollinsCarol M Ashton

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Citations

Oct 13, 2006·Heart·Daniel G Hackam, John W Eikelboom
Aug 9, 2012·Thrombosis and Haemostasis·Eline S Van HattumAle Algra
Mar 9, 2007·World Journal of Surgery·Xinwen WangChangyi Chen
Aug 9, 2005·American Heart Journal·Daniel G HackamSonia S Anand
Jun 10, 2005·Journal of Vascular Surgery·Daniel G Hackam
Aug 21, 2007·Vascular and Endovascular Surgery·Irwin V MohanGerard P Stansby
Jul 25, 2012·Circulation·Jeffrey S Berger, William R Hiatt
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Stephanie S DeLoach, Emile R Mohler
Jun 17, 2009·Expert Opinion on Pharmacotherapy·Andrew B McCann, Michael R Jaff
Dec 7, 2019·The British Journal of Surgery·G K AmblerC P Twine
Jan 7, 2021·ANZ Journal of Surgery·Sam FarahUNKNOWN Australian and New Zealand Vascular Trials Network

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