Trial of low-dose aspirin plus dipyridamole versus anticoagulants for prevention of aortocoronary vein graft occlusion.
In a prospective randomised trial, 249 patients who had aortocoronary vein bypass surgery were assigned either to a platelet inhibitory drug regimen or to standard anticoagulant therapy. Treatment was replaced by placebo in half of the patients in each group after 3 months. The platelet inhibitory drug regimen--very low-dose aspirin combined with dipyridamole--was as effective as standard anticoagulant therapy to prevent early and late graft occlusion. Death, myocardial infarction, and severe bleeding occurred significantly more often in patients receiving anticoagulants, whereas mild drug-related gastrointestinal and cerebral side-effects were more common in patients taking platelet inhibitory drugs. Antithrombotic treatment should be continued for at least 1 year after coronary artery bypass graft surgery.
Pfisterer
M
M
Division of Cardiology, University Hospital, Basel, Switzerland.
Burkart
F
F
Jockers
G
G
Meyer
B
B
Regenass
S
S
Burckhardt
D
D
Schmitt
H E
HE
Müller-Brand
J
J
Skarvan
K
K
Stulz
P
P
D015110:4-Hydroxycoumarins / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000517:prevention & control*; D003328:Coronary Thrombosis / Q000517:prevention & control*; D004176:Dipyridamole / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010644:Phenprocoumon / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D011446:Prospective Studies; D011897:Random Allocation; D012501:Saphenous Vein / Q000637:transplantation
D015110:4-Hydroxycoumarins; D010975:Platelet Aggregation Inhibitors; D004176:Dipyridamole; D010644:Phenprocoumon; D001241:Aspirin