[How long should antithrombotic therapy be continued following aortocoronary bypass surgery?].
In a prospective randomized trial the effect of prolonged antithrombotic treatment with anticoagulants or antiplatelet drugs (50 mg aspirin + 400 mg dipyridamole daily) on late bypass-graft occlusion was studied. After 3 months active treatment was replaced by placebo in half of the patients. Between the angiographic checkups 2 weeks and 12 months postoperatively, 28/330 (8%) new graft occlusions had occurred on continued therapy, versus 44/319 (14%) on placebo (p = 0.03). This difference was most pronounced in individual grafts (6% vs 12%, p = 0.01), so that fewer patients with 12 months' active therapy had at least one occluded graft (22% versus 32%, p = 0.08). These findings suggest that antithrombotic treatment should not be halted 3 months after CABG surgery but should be continued for at least one year and possibly longer.
Pfisterer
M
M
Departement Innere Medizin, Universitätskliniken Basel.
Jockers
G
G
Regenass
S
S
Schmitt
H E
HE
Grädel
E
E
Burkart
F
F
D015110:4-Hydroxycoumarins / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D004176:Dipyridamole / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010644:Phenprocoumon / Q000627:therapeutic use*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D014654:Vascular Patency
D015110:4-Hydroxycoumarins; D004176:Dipyridamole; D010644:Phenprocoumon; D001241:Aspirin
Wie lange soll die antithrombotische Therapie nach aortokoronarer Bypassoperation fortgeführt werden?