Use of aspirin and clopidogrel after coronary artery bypass graft surgery

The Annals of Pharmacotherapy
Noelle de Leon, Cynthia A Jackevicius

Abstract

To evaluate the evidence for the use of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel following coronary artery bypass graft (CABG) surgery. Literature was accessed through PubMed (1950-November 2011), EMBASE (1976-November 2011), and the Cochrane databases using the terms clopidogrel and coronary artery bypass graft. Citations from available articles were used for additional references and ClinicalTrials.gov was accessed for abstracts of ongoing studies. Peer-reviewed studies that evaluated DAPT use after CABG surgery in adult humans were assessed for inclusion. Four randomized clinical trials evaluating surrogate end points and 9 studies (3 subgroup analyses, 6 observational) evaluating clinical outcomes were reviewed. Three clinical trials assessing surrogate end points failed to demonstrate an improvement in graft patency with DAPT use, while 1 clinical trial found an increase in graft patency. As for clinical outcomes, 1 subgroup analysis demonstrated that the benefit of DAPT post-CABG after a non-ST-elevation acute coronary syndrome diminished following surgery, while an observational study demonstrated a trend toward decreased mortality. In post-CABG patients who did not experience acute coronary syndrome...Continue Reading

References

Sep 1, 1996·The Annals of Thoracic Surgery·E D Verrier, E M Boyle
Jun 17, 1998·The Journal of Thoracic and Cardiovascular Surgery·S R GundryL L Bailey
Nov 14, 1998·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·D Bouchard, R Cartier
Sep 21, 2000·The Journal of Clinical Investigation·D M Center
Aug 25, 2001·The New England Journal of Medicine·S YusufUNKNOWN Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Sep 22, 2001·The Annals of Thoracic Surgery·K B KimY B Park
Oct 25, 2002·The New England Journal of Medicine·Dennis T Mangano, UNKNOWN Multicenter Study of Perioperative Ischemia Research Group
Nov 19, 2002·JAMA : the Journal of the American Medical Association·Steven R SteinhublUNKNOWN CREDO Investigators. Clopidogrel for the Reduction of Events During Observation
Jan 4, 2006·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ahmet Tayfun GurbuzAydin Aytac
Feb 21, 2006·The Annals of Thoracic Surgery·Michael E HalkosRobert A Guyton
Mar 15, 2006·The New England Journal of Medicine·Deepak L BhattUNKNOWN CHARISMA Investigators
Oct 25, 2006·The Heart Surgery Forum·Khalid IbrahimRune Haaverstad
Sep 14, 2007·Scandinavian Cardiovascular Journal : SCJ·Allan Bybeck NielsenDaniel A Steinbrüchel
Nov 28, 2007·Journal of Cardiac Surgery·Vincent ChanMarc Ruel
Dec 18, 2008·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Saurabh SanonJames M Wilson
Nov 26, 2009·The Journal of Thoracic and Cardiovascular Surgery·Dae Hyun KimDavid J Whellan
Feb 4, 2010·Circulation·Paul A Gurbel, Udaya S Tantry
Dec 17, 2010·Circulation·Véronique L RogerUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Mar 5, 2011·Journal of the American College of Cardiology·Rikke SørensenChristian Torp-Pedersen

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Citations

Oct 3, 2013·European Heart Journal·Stuart J HeadArie Pieter Kappetein
Oct 30, 2012·The American Journal of Cardiology·Ralf E HarskampRobbert J de Winter
Dec 21, 2014·Seminars in Thoracic and Cardiovascular Surgery·Victor A Ferraris, Michael D Bolanos
Feb 14, 2015·Circulation·Alexander KulikUNKNOWN American Heart Association Council on Cardiovascular Surgery and Anesthesia
Mar 13, 2019·Transfusion Medicine·I PerelmanD Fergusson
Apr 4, 2015·Chinese Medical Sciences Journal = Chung-kuo I Hsüeh K'o Hsüeh Tsa Chih·Song WuJi-yan Xie
Dec 6, 2019·Cardiology in Review·David Collins, Sheldon Goldberg
Jun 6, 2018·European Heart Journal Supplements : Journal of the European Society of Cardiology·Michele Massimo GuliziaUNKNOWN Faculty for approval of the Consensus Document
May 21, 2020·The Journal of Cardiovascular Surgery·João N Rocha-GomesAdelino F Leite-Moreira
Jan 14, 2017·Journal of the American College of Cardiology·Sean van DiepenMichael E Farkouh

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