Combination therapy with warfarin plus clopidogrel improves outcomes in femoropopliteal bypass surgery patients

Journal of Vascular Surgery
Mario MonacoPaolo Stassano

Abstract

Patients having undergone femoropopliteal bypass surgery remain at significant risk of graft failure. Although antithrombotic therapy is of paramount importance in these patients, the effect of oral anticoagulation therapy (OAT) on outcomes remains unresolved. We performed a randomized, prospective study to assess the impact of OAT plus clopidogrel vs dual antiplatelet therapy on peripheral vascular and systemic cardiovascular outcomes in patients who had undergone femoropopliteal bypass surgery. Three hundred forty-one patients who had undergone femoropopliteal surgery were enrolled and randomized: 173 patients received clopidogrel 75 mg/d plus OAT with warfarin (C + OAT), and 168 patients received dual antiplatelet therapy with clopidogrel 75 mg/d plus aspirin 100 mg/d (C + acetylsalicylic acid [ASA]). Study end points were graft patency and the occurrence of severe peripheral arterial ischemia, and the incidence of bleeding episodes. Follow-up ranged from 4 to 9 years. The graft patency rate and the freedom from severe peripheral arterial ischemia was significantly higher in C + OAT group than in C + ASA group (P = .026 and .044, respectively, Cox-Mantel test). The linearized incidence of minor bleeding complications was sig...Continue Reading

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Citations

Dec 3, 2014·Journal of Vascular Surgery·Mario Maufus, Gilles Pernod
May 5, 2016·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·E GándaraS Nagpal
May 24, 2016·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Soo Hyun LeeEunsook Ma
May 28, 2014·Current Problems in Surgery·Mark L FriedellRobert R Carter
Dec 4, 2019·VASA. Zeitschrift für Gefässkrankheiten·Ulrich FrankPiotr Terlecki
Feb 20, 2015·The Cochrane Database of Systematic Reviews·Rachel BedenisMartin H Prins
May 20, 2016·Nature Reviews. Cardiology·Margreet R de VriesPaul H A Quax
Jan 14, 2020·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Daria ZavgorodnyayaPedro G Teixeira
Feb 22, 2021·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Kristin R Hand, Genevieve M Hale

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