Key result
Aspirin plus clopidogrel was not associated with improved 4-year survival compared to aspirin alone after coronary artery bypass graft surgery (OR 1.055; 95% CI 0.7-1.4; P=.72).
Why the study?
Does aspirin plus clopidogrel improve survival compared to aspirin alone in patients after coronary artery bypass graft surgery?
Observational (n=4,297)
Does aspirin plus clopidogrel improve survival compared to aspirin alone in patients after coronary artery bypass graft surgery?
Odds Ratio: 1.055 (95% CI 0.7–1.4)
Absolute Event Rate: 87.9% vs 88.8%
p-value: p=.72
Dual antiplatelet therapy with aspirin and clopidogrel at discharge after CABG surgery does not provide a survival benefit over aspirin alone at 4 years.
No survival benefit with dual antiplatelet therapy after CABG; leaves open confirmation in randomized trials.
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.
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Sanon et al. (2008) conducted an observational in Post coronary artery bypass graft surgery (n=4,297). Aspirin plus clopidogrel vs. Aspirin only was evaluated on Survival (OR 1.055, 95% CI 0.7-1.4, p=.72). Aspirin plus clopidogrel was not associated with improved 4-year survival compared to aspirin alone after coronary artery bypass graft surgery (OR 1.055; 95% CI 0.7-1.4; P=.72).
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