Clopidogrel is safe early after on- and off-pump coronary artery bypass surgery.
OBJECTIVE
The goal of this study was to assess the safety of early postoperative clopidogrel in patients undergoing on-pump and off-pump coronary artery bypass graft (CABG) surgery.


METHODS
Observational data was collected prospectively on 117 consecutive patients who underwent primary multivessel CABG between July 2002 and June 2005. When postoperative chest tube drainage was < or =50 cc/h for 2 hours, daily clopidogrel (75 mg) and aspirin (81 mg) were initiated in 63 patients (Group CA) versus aspirin alone in 54 patients (Group A). Demographic, operative, and postoperative data were compared with linear regression and propensity-score based techniques.


RESULTS
Total chest tube drainage and drainage after patients received antiplatelet agents were equivalent between groups. Clopidogrel administration did not increase the incidence of reexploration, transfusion, or the quantity of blood products transfused. No mortality or extrathoracic bleeding occurred in either group, and there were no differences in the incidence of adverse myocardial events or hospital length of stay.


CONCLUSIONS
When given according to a predefined postoperative protocol, early postoperative clopidogrel can safely be administered in on-pump and off-pump CABG patients, without increasing the risk of bleeding complications. Evaluation of the benefits of clopidogrel therapy early after CABG in a randomized setting is ongoing.
Division of Cardiac Surgery, University of Ottawa, Ottawa, Ontario, Canada.
Vincent
V
Chan
Alexander
A
Kulik
Michael E
ME
Bourke
Ladislaus
L
Ressler
Thierry G
TG
Mesana
Marc
M
Ruel
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D015505:Chest Tubes; D000077144:Clopidogrel; D001026:Coronary Artery Bypass; D047549:Coronary Artery Bypass, Off-Pump; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin