Relationship between postoperative clopidogrel use and subsequent angiographic and clinical outcomes following coronary artery bypass grafting View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-11

AUTHORS

Judson B. Williams, Renato D. Lopes, Gail E. Hafley, T. Bruce Ferguson, Michael J. Mack, C. Michael Gibson, Robert A. Harrington, Eric D. Peterson, Peter K. Smith, Rajendra H. Mehta, John H. Alexander

ABSTRACT

Dual antiplatelet therapy with both aspirin and clopidogrel is increasingly used after coronary artery bypass grafting (CABG); however, little is known about the safety or efficacy. We sought to determine the relationship between postoperative clopidogrel and clinical and angiographic outcomes following CABG. We evaluated 3,014 patients from PREVENT IV who underwent CABG at 107 US sites. Postoperative antiplatelet therapy was left to physician discretion. Risk-adjusted angiographic and clinical outcomes were compared in patients taking and not taking clopidogrel 30 days post-CABG. At 30 days, 633 (21%) patients were taking clopidogrel. Clopidogrel users were more likely to have peripheral vascular (15 vs. 11%) and cerebrovascular disease (17 vs. 11%), prior myocardial infarction (MI) (46 vs. 41%), and off-pump surgery (33 vs. 18%). Clopidogrel use was associated with statistically insignificant higher graft failure (adjusted odds ratio 1.3; 95% confidence interval [CI] [1.0, 1.7]; P = 0.05). At 5-year follow-up, clopidogrel use was associated with similar composite rates of death, MI, or revascularization (27 vs. 24%; adjusted hazard ratio 1.1; 95% CI [0.9, 1.4]; P = 0.38) compared with those not using clopidogrel. There was an interaction between use of cardiopulmonary bypass and clopidogrel with a trend toward lower 5-year clinical events with clopidogrel in patients undergoing off-pump CABG. In this observational analysis, clopidogrel use was not associated with better 5-year outcomes following CABG. There may be better outcomes with clopidogrel among patients having off-pump surgery. Adequately powered randomized clinical trials are needed to determine the role of dual antiplatelet therapy after CABG. More... »

PAGES

384-393

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11239-013-0904-1

DOI

http://dx.doi.org/10.1007/s11239-013-0904-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1042564584

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23543398


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Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

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Turtle is a human-readable linked data format.

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RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s11239-013-0904-1'


 

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