Why the study?
Does clopidogrel 75 mg improve platelet inhibition and reduce hypercoagulability in patients after OPCAB surgery?
Does clopidogrel 75 mg improve platelet inhibition and reduce hypercoagulability in patients after OPCAB surgery?
Clopidogrel significantly increases platelet inhibition after OPCAB surgery, though hypercoagulability peaks at 5 days regardless of treatment.
Clopidogrel enhances platelet inhibition after OPCAB; extends RCT evidence supporting antiplatelet intensification in coronary bypass patients.
OBJECTIVE: Data on graft patency after Off-Pump Coronary Artery Bypass (OPCAB) suggest that the incidence of early graft closure is not increased compared to conventional coronary artery bypass surgery. However, hypercoagulability following OPCAB is still of concern, and acetylsalicylic acid as thromboembolic prophylaxis might be insufficient in the first weeks following OPCAB surgery. DESIGN: Twenty nine patients were randomly assigned to+/- 75 mg of clopidogrel until 30 days after OPCAB surgery. The follow-up time was 2 months including standard blood samples and thrombelastography (TEG) with a specific platelet inhibition assay, which was evaluated as a part of the study. RESULTS: In both groups a significant increase in TEG maximum amplitude was found 5 days after surgery. Platelet inhibition showed great variations but was significantly increased in the clopidogrel group (34.1%) vs. control group (11.0%) after 1 month. CONCLUSION: Hypercoagulability was seen 5 days after OPCAB and could not be demonstrated after 1 month. No clinical effects of the hypercoagulability were observed, and further research is needed to determine if clopidogrel should be recommended after OPCAB.
No takes yet. Share an insight, caveat, or question.
Nielsen et al. (2007) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: