Use of aspirin versus clopidogrel plus aspirin after coronary artery bypass graft surgery.
Aspirin and clopidogrel together reduce the risk of recurrent thrombosis-related events in patients with acute coronary syndromes or stent revascularization and may reduce thrombosis-induced saphenous vein graft failure. In this retrospective, observational study, 4297 patients were assigned to 2 groups after coronary artery bypass graft surgery, based on medications prescribed at hospital discharge: aspirin only (n = 3318) or aspirin plus clopidogrel (n = 979). At 4-year follow-up, unadjusted survival was similar between the 2 groups (aspirin-clopidogrel, 87.9% vs aspirin-only, 88.8%, P = .43). After statistical adjustment using Cox regression analysis, dual anti-platelet therapy at hospital discharge was not associated with improved survival (odds ratio 1.055, 95% confidence interval 0.7-1.4, P = .72). In propensity score-based, case-matched populations (962 patients each), similar results were obtained (odds ratio 0.996, 95% confidence interval 0.7-1.4, P = .98). In our study population, aspirin plus clopidogrel did not provide survival benefit over treatment with aspirin alone in 4 years after coronary artery bypass graft surgery.
Sanon
Saurabh
S
Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Lee
Vei-Vei
VV
Elayda
MacArthur
M
Wilson
James M
JM
D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D000077144:Clopidogrel; D001026:Coronary Artery Bypass / Q000379:methods*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin