Prevention of aortocoronary vein-graft attrition with low-dose aspirin and triflusal, both associated with dipyridamole: a randomized, double-blind, placebo-controlled trial.
A randomized, double-blind, placebo-controlled trial was performed in 209 patients to evaluate the efficacy of a low dose of aspirin plus dipyridamole or that of a new antiplatelet agent (triflusal) plus dipyridamole in the prevention of aortocoronary vein-graft occlusion. An angiographic control performed in 161 patients 9 days after surgery showed no significant differences between groups, but a new control on 138 of those patients 6 months later did show significant linear trends towards fewer distal anastomosis occlusions (P = 0.027) from the placebo (24%, 22/91) to the aspirin (16%, 17/106) and to the trifusal groups (12%, 10/86), and towards fewer new occlusions (P = 0.056) from 12% (9/78) to 10% (10/99) and to 2.6% (2/78), respectively, in the same groups. A multivariate logistic regression model, used to determine the effect of 33 variables on distal anastomosis occlusion at 6 months control, demonstrated that diameter of distal bed (P = 0.006), moderately to severely atherosclerotic distal bed (P = 0.003) and the interactions between poor distal bed and triflusal (P = 0.005) were independent predictors of occlusion. Thus, triflusal plus dipyridamole appeared superior to low-dose aspirin plus dipyridamole in the prevention of vein-graft occlusion, independently of coronary and vein-graft determinants of occlusion.
Guiteras
P
P
Cardiac Catheterization and Invasive Cardiology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Altimiras
J
J
Arís
A
A
Augé
J M
JM
Bassons
T
T
Bonal
J
J
Caralps
J M
JM
Castellarnau
C
C
Crexells
C
C
Masotti
M
M
D000328:Adult; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D002986:Clinical Trials as Topic; D001026:Coronary Artery Bypass; D004176:Dipyridamole / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D011897:Random Allocation; D012459:Salicylates / Q000008:administration & dosage* / Q000009:adverse effects; D014654:Vascular Patency / Q000187:drug effects*
D012459:Salicylates; C016167:triflusal; D004176:Dipyridamole; D001241:Aspirin