Secondary prevention after coronary artery bypass grafting: Anticoagulation and antiplatelet therapy is only one factor

Abstract

Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel/ticagrelor/prasugrel does not lead to improved graft patency rates or clinical outcomes after coronary artery bypass grafting (CABG) over aspirin monotherapy, at least for on pump CABG. The protective effects of DAPT tended to be observed to be greater extent in patients undergoing off pump CABG. In general, the addition of the potent thienopyridines increased the risk of major bleeding, although the incidence of major bleeding is relatively low after either on pump or off pump surgical revascularization. There is a lack of evidence that anticoagulation post‐CABG provides any protection against graft failure, but it may decrease the incidence of major adverse cardiovascular events. However, antiplatelet and anti thrombotic therapy after CABG is only one component of secondary prevention that needs to be taken into consideration when optimizing the long‐term outcomes of patients after CABG.

Type two diabetes mellitus and microvascular complications in patients with coronary artery disease: prevalence, prognosis and choice of antithrombotic therapy

“…у 20,3% давность выполнения чкв была от 1 до 2 лет, у 12% больных -от 2 до 3 лет, у 62,2% -более 3 лет. независимо от наличия в анамнезе больных [67]. защитные эффекты двойной антитромбоцитарной терапии, как правило, наблюдались только у пациентов, перенёсших кш без применения аппарата искусственного кровообращения.…”