Coronary Artery DiseaseMeta-Analysis of Effect of Single Versus Dual Antiplatelet Therapy on Early Patency of Bypass Conduits After Coronary Artery Bypass Grafting
Section snippets
Methods
We carried out a comprehensive published works search of PubMed (http://www.ncbi.nlm.nih.gov/pubmed). The following keywords were used in the search: (“Aspirin and Clopidogrel” and “Coronary Artery Bypass” and “Graft Patency”). The search also included review of bibliographies of selected studies. To be eligible for this study, the deadline for publication was March 2013. No unpublished trials were included.
Studies included in the analysis had to meet all of the flowing criteria: (1) randomized
Results
Table 1 lists the characteristics of the 5 randomized trials included in this analysis. A total of 958 patients were randomly assigned to receive either mono- or dual antiplatelet therapy. All studies enrolled patients who were aged ≥59 years, with most being men (85%). A total of 878 patients completed the follow-up assessments, ranging from 30 days to 12 months after coronary bypass surgery. Four of the studies used multidetector computed tomography angiography and 1 study used invasive
Discussion
This quantitative systematic review identified 5 randomized clinical trials with a total of 958 patients treated with antiplatelet regimens, including monotherapy of dual therapy for the purpose of increasing bypass patency. During a treatment duration of up to 1 year, single antiplatelet therapy led to a significantly higher 4.2% absolute risk of venous graft occlusion versus dual antiplatelet therapy. In contrast, arterial grafts did not benefit from this intensified therapeutic approach,
Disclosures
The authors have no conflicts of interest to disclose.
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2020, Journal of the American College of CardiologyCitation Excerpt :The most recent data, however, suggest that DAPT may have a role in preventing graft occlusion. Results of meta-analyses, carried out to compare graft patency in patients treated with aspirin alone or aspirin + clopidogrel after CABG, suggest that DAPT was associated with a significant reduction in saphenous vein graft occlusions (27–29). This finding has been recently confirmed by Zhao et al. (30) in a multicenter open-label clinical trial on 500 elective CABG patients carried out to compare the effect of ticagrelor + aspirin versus monotherapy with either aspirin or ticagrelor.
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