American Journal of Cardiology
Volume 103, Issue 12 , Pages 1687-1693 , 15 June 2009

Evidence for Using Clopidogrel Alone or in Addition to Aspirin in Post Coronary Artery Bypass Surgery Patients

  • Jigar H. Patel, MD

      Affiliations

    • Department of Medicine, Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
    • Corresponding Author InformationCorresponding author: Tel: 405-271-4742; fax: 405-271-2679
    • ,
  • Julie A. Stoner, PhD

      Affiliations

    • Department of Biostatistics and Epidemiology, Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
    • ,
  • Arthur Owora, BS

      Affiliations

    • Department of Biostatistics and Epidemiology, Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
    • ,
  • Sunil T. Mathew, MD

      Affiliations

    • Department of Medicine, Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
    • ,
  • Udho Thadani, MD

      Affiliations

    • Department of Medicine, Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
    • Veterans Affairs Medical Center, Oklahoma City, Oklahoma
    • Corresponding Author InformationCorresponding author: Tel: 405-271-4742; fax: 405-271-2679

Received 4 December 2008 ,Revised 5 February 2009 ,Accepted 5 February 2009.

References 

  1. Stein PD, Schunemann HJ, Dalen JE, Gutterman D. Antithrombotic therapy in patients with saphenous vein and internal mammary artery bypass grafts: the Seventh ACCP Conference on antithrombotic and thrombolytic therapy. Chest. 2004;126:600S–608S
  2. von Heymann C, Redlich U, Moritz M, Sander M, Vargas Hein O, Grubitzsch H, et al. Aspirin and clopidogrel taken until 2 days prior to coronary artery bypass graft surgery is associated with increased postoperative drainage loss. J Thorac Cardiovasc Surg. 2005;53:341–345
  3. Kapetanakis EI, Medlam DA, Boyce SW, Haile E, Hill PC, Dullum MK, et al. Clopidogrel administration prior to coronary artery bypass grafting surgery: the cardiologist's panacea or the surgeon's headache?. Eur Heart J. 2005;26:576–583
  4. Filsoufi F, Rahmanian PB, Castillo JG, Kahn RA, Fischer G, Adams DH. Clopidogrel Treatment before coronary artery bypass graft surgery increases postoperative morbidity and blood product requirements. J Cardiothorac Vasc Anesth. 2008;22:60–66
  5. Nurozler F, Kutlu T, Kucuk G, Okten C. Impact of clopidogrel on postoperative blood loss after non-elective coronary bypass surgery. Interact Cardiovasc Thorac Surg. 2005;4:546–549
  6. Ray JG, Deniz S, Olivieri A, Pollex E, Vermeulen MJ, Alexander KS, et al. Increased blood product use among coronary artery bypass patients prescribed preoperative aspirin and clopidogrel. BMC Cardiovasc Disord. 2003;3:3
  7. Englberger L, Faeh B, Berdat PA, Eberli F, Meier B, Carrel T. Impact of clopidogrel in coronary artery bypass grafting. Eur J Cardiothorac Surg. 2004;26:96–101
  8. Ascione R, Ghosh A, Rogers CA, Cohen A, Monk C, Angelini GD. In-hospital patients exposed to clopidogrel before coronary artery bypass graft surgery: a word of caution. Ann Thorac Surg. 2005;79:1210–1216
  9. Hongo RH, Ley J, Dick SE, Yee RR. The effect of clopidogrel in combination with aspirin when given before coronary artery bypass grafting. J Am Coll Cardiol. 2002;40:231–237
  10. Yende S, Wunderink RG. Effect of clopidogrel on bleeding after coronary artery bypass surgery. Crit Care Med. 2001;29:2271–2275
  11. Kang W, Theman TE, Reed JF, Stoltzfus J, Weger N. The effect of preoperative clopidogrel on bleeding after coronary artery bypass surgery. J Surg Educ. 2007;64:88–92
  12. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996;17:1–12
  13. Higgins JPT, Green S, editors. Assessment of Study Quality. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6 (updated September 2006); Section 6. In: The Cochrane Library, Issue 4, 2006. Chichester, UK: John Wiley & Sons, Ltd.
  14. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001;345:494–502
  15. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet. 1996;348:1329–1339
  16. Steinhubl SR, Berger PB, Mann JT, Fry ET, DeLago A, Wilmer C, et al. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002;288:2411–2420
  17. Bhatt DL, Fox KA, Hacke W, Berger PB, Black HR, Boden WE, et al Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med. 2006;354:1706–1717
  18. Fox KA, Mehta SR, Peters R, Zhao F, Lakkis N, Gersh BJ, et al. Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation acute coronary syndrome: the Clopidogrel in Unstable Angina to Prevent Recurrent Ischemic Events (CURE) trial. Circulation. 2004;110:1202–1208
  19. Bhatt DL, Chew DP, Hirsch AT, Ringleb PA, Hacke W, Topol EJ. Superiority of clopidogrel versus aspirin in patients with prior cardiac surgery. Circulation. 2001;103:363–368
  20. Saw J, Topol EJ, Steinhubl SR, Brennan D, Berger PB, Moliterno DJ. Comparison of long-term usefulness of clopidogrel therapy after the first percutaneous coronary intervention or coronary artery bypass grafting versus that after the second or repeat intervention. Am J Cardiol. 2004;94:623–625
  21. Lim E, Cornelissen J, Routledge T, Kirtland S, Charman SC, Bellm S, et al. Clopidogrel did not inhibit platelet function early after coronary bypass surgery: a prospective randomized trial. J Thorac Cardiovasc Surg. 2004;128:432–435
  22. David JL, Limet R. Antiplatelet activity of clopidogrel in coronary artery bypass graft surgery patients. Thromb Haemost. 1999;82:1417–1421
  23. Shennib H, Endo M, Benhameid O. A feasibility study of the safety and efficacy of a combined clopidogrel and aspirin regimen following off-pump coronary artery bypass grafting. Heart Surg Forum. 2003;6:288–291
  24. Gurbuz AT, Zia AA, Vuran AC, Cui H, Aytac A. Postoperative clopidogrel improves mid-term outcome after off-pump coronary artery bypass graft surgery: a prospective study. Eur J Cardiothorac Surg. 2006;29:190–195
  25. Halkos ME, Cooper WA, Petersen R, Puskas JD, Lattouf OM, Craver JM, et al. Early administration of clopidogrel is safe after off-pump coronary artery bypass surgery. Ann Thorac Surg. 2006;81:815–819
  26. Ibrahim K, Tjomsland O, Halvorsen D, Wiseth R, Wahba A, Karevold A, et al. Effect of clopidogrel on midterm graft patency following off-pump coronary revascularization surgery. Heart Surg Forum. 2006;9:E581–E856
  27. Nielsen AB, Bochsen L, Steinbruchel DA. Hypercoagulability and platelet inhibition after OPCAB (Randomized intervention with clopidogrel). Scand Cardiovasc J. 2007;41:325–330
  28. Kulik A, Le May M, Wells GA, Mesana TG, Ruel M. The Clopidogrel After Surgery for Coronary Artery Disease (CASCADE) randomized controlled trial: clopidogrel and aspirin versus aspirin alone after coronary bypass surgery. [NCT00228423] Curr Control Trials Cardiovasc Med. 2005;6:15
  29. Mangano DT. Aspirin and mortality from coronary bypass surgery. N Engl J Med. 2002;347:1309–1317

PII: S0002-9149(09)00603-1

doi: 10.1016/j.amjcard.2009.02.021

American Journal of Cardiology
Volume 103, Issue 12 , Pages 1687-1693 , 15 June 2009

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