The Effect of Combined Clopidogrel and Aspirin Therapy after Off-Pump Coronary Surgery

Mujanovic, Emir; Nurkic, Midhat; Caluk, Jasmin; Terzić, Ibrahim; Kabil, Emir; Bergsland, Jacob

doi:10.1177/155698450900400507

Cited by 4 publications

(10 citation statements)

References 20 publications

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“…A total of 696 articles were identified with the literature search. Eleven studies (five randomized control trials and six observational studies) [8][9][10][11][12][13][16][17][18][19][20] comprising a pooled cohort of 25,728 patients met our criteria and were included in this meta-analytical review. Selection of articles for inclusion in this study resulted in a Cohens k score of 0.90.…”

Section: Resultsmentioning

confidence: 99%

“…Characteristics of the included studies in reported in Tables 1 and 2. Most studies included patients undergoing both on-and off-pump CABG; however, four studies 9,12,13,16 included patients with off-pump CABG.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies implemented a loading dose of the medications after chest tube drain had reduced. 9,11,13 The dose of aspirin was 81, 100, or 325 mg orally. Clopidogrel administration was more uniform at 75 mg orally daily.…”

Section: Protocol Of Aspirin W Clopidogrel Therapy In Various Studiesmentioning

confidence: 99%

“…Five randomized controlled trials [8][9][10][11][12] evaluated graft patency among patients treated with aspirin þ clopidogrel versus aspirin alone using coronary angiography 8,9 or multi-slice computerized tomography. [10][11][12] All studies evaluated graft patency as a part of their protocol and this decision was not based on symptomatology.…”

Section: Saphenous Vein Graft Patencymentioning

confidence: 99%

“…Four studies 9,12,13,16 selectively implemented only off-pump coronary revascularization. Among patients undergoing off-pump CABG (two observational studies þ one RCT) 12,13,16 dual anti-platelet therapy was associated with reduced cardiac events compared with aspirin alone (RR ¼ 0.29, 95% CI 0.11-0.72, p ¼ 0.008).…”

Section: Sub-group Analysis In Studies Implementing Off-pump Cabgmentioning

confidence: 99%

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Dual Anti-platelet Therapy After Coronary Artery Bypass Grafting: Is There Any Benefit? A Systematic Review and Meta-Analysis

et al. 2013

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Protocol Of Aspirin W Clopidogrel Therapy In Various Studiesmentioning

confidence: 99%

Section: Saphenous Vein Graft Patencymentioning

confidence: 99%

Section: Sub-group Analysis In Studies Implementing Off-pump Cabgmentioning

confidence: 99%

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Dual Anti-platelet Therapy After Coronary Artery Bypass Grafting: Is There Any Benefit? A Systematic Review and Meta-Analysis

et al. 2013

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Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events

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Bellesini

Takeda

et al. 2017

Cochrane Database of Systematic Reviews

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Anticoagulation and antiplatelet therapy post coronary artery bypass surgery

et al. 2021

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Background Coronary artery bypass grafting (CABG) is the gold standard treatment for patients with multivessel coronary heart disease. Although its use has proven long‐term survival benefits, there is a relative degree of graft failure which increases morbidity and mortality rates. Discussion This review discusses clinical outcomes following antiplatelet and anticoagulant therapy after CABG. There is wide variation of evidence about the use of clopidogrel or ticagrelor to aspirin postoperatively in relation to improving graft patency rates or clinical outcomes over the use of aspirin alone. These dual therapies may have significant protective effects in patients undergoing off‐pump CABG. Recent studies suggest that superior outcomes may be attained by combining prasugrel with aspirin. Further research is needed to evaluate this, as well as compare the effectiveness of different dual antiplatelet regimens. There is weak evidence for post‐CABG anticoagulation, with warfarin and rivaroxaban providing no protection against graft failure but decreasing long‐term major adverse cardiac events. Anticoagulation seems to be indicated only in post‐CABG patients at high risk of future ischemic events. Conclusion The use of dual anti‐platelet therapy post coronary artery bypass surgery needs further research. Potentially, selective patient groups will benefit more from the addition of thienopyridine antiplatelets or anticoagulants to aspirin after CABG.

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The Effect of Combined Clopidogrel and Aspirin Therapy after Off-Pump Coronary Surgery

Cited by 4 publications

References 20 publications

Dual Anti-platelet Therapy After Coronary Artery Bypass Grafting: Is There Any Benefit? A Systematic Review and Meta-Analysis

Dual Anti-platelet Therapy After Coronary Artery Bypass Grafting: Is There Any Benefit? A Systematic Review and Meta-Analysis

Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events

Anticoagulation and antiplatelet therapy post coronary artery bypass surgery

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