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Clopidogrel and aspirin versus clopidogrel alone on graft patency after coronary artery bypass grafting

Changqing Gao1, Chonglei Ren, Dong Li

  • 1Department of Cardiovascular Surgery, PLA General Hospital, PLA Institute of Cardiac Surgery, Beijing, China. gaochq301@yahoo.com

The Annals of Thoracic Surgery
|June 30, 2009
PubMed

Insights

Clopidogrel with aspirin or alone maintains high graft patency after coronary artery bypass grafting (CABG). Both antiplatelet therapies showed similar effectiveness in keeping grafts open long-term.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Pharmacology

Background:

  • Coronary artery bypass grafting (CABG) commonly uses antiplatelet agents like clopidogrel and aspirin.
  • Optimal antiplatelet therapy post-CABG and its effect on graft patency remain unclear.

Purpose of the Study:

  • To compare the efficacy of clopidogrel alone versus clopidogrel plus aspirin on graft patency after CABG.
  • To evaluate long-term graft patency rates in patients receiving different antiplatelet regimens post-CABG.

Main Methods:

  • A study involving 197 patients undergoing CABG.
  • Patients were randomized to receive either clopidogrel (75 mg daily) or a combination of clopidogrel (75 mg daily) and aspirin (100 mg daily).
  • Graft patency was assessed using multislice computed tomography angiography at 1 and 12 months post-CABG.

Main Results:

  • No significant differences in pre-operative data between the groups.
  • Graft patency rates at 12 months were high in both groups: Left Internal Mammary Artery (LIMA) (96.9% clopidogrel vs. 97.8% combination) and saphenous vein grafts (93.5% clopidogrel vs. 96.3% combination).
  • No statistically significant difference in graft patency was observed between the clopidogrel and combination therapy groups (p > 0.05).

Conclusions:

  • Both clopidogrel plus aspirin and clopidogrel monotherapy achieve high graft patency rates in the early and late postoperative phases following CABG.
  • While a trend towards higher patency with combination therapy was noted, it did not reach statistical significance.
  • These findings suggest that either regimen can be considered for maintaining graft patency post-CABG.
Abstract

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