Key result
Clopidogrel plus aspirin resulted in significantly less bleeding compared to aspirin alone during the three days following off-pump coronary artery bypass graft surgery (P=0.013).
Why the study?
Clopidogrel improves intravascular stent patency and reduces ischemic events, but there are little data on its effect following OPCAB.
Does clopidogrel plus aspirin reduce bleeding compared to aspirin alone in patients following off-pump coronary artery bypass graft surgery?
RCT (n=413)
randomized
Does clopidogrel plus aspirin reduce bleeding compared to aspirin alone in patients following off-pump coronary artery bypass graft surgery?
p-value: p=0.013
The addition of clopidogrel to aspirin for three days following off-pump CABG was paradoxically associated with significantly less bleeding compared to aspirin alone.
Supports early DAPT after OPCAB without excess bleeding; extends limited prior RCT data on graft outcomes.
Introduction: Clopidogrel improves intravascular stent patency reduces ischemic events but there are little data on its effect fallowing OPCAB. This study was designed to Material and Method: In this randomized clinical trial, 413 patients undergoing OPCAB were randomized to receive aspirin 80 mg plus Clopidogrel 75 mg (n=214, intervention group) or aspirin 80 mg (n=199, control group) for three days after surgery and then were treated in accordance with the common guidelines. Patients with coagulation disorders and those who rejected taking drugs were excluded. The data were then analyzed by using Student t-test and Chi-square test through SPSS ver. 20. Result: Mean age of patients was 61.081 ± 10.84 years. There was no significant difference between in two groups in pre and perioperation data. Mean of bleeding in the mean of bleeding during three days between two groups (p: 0.013). Conclusion: According to our findings patients treated with Clopidogrel plus aspirin had significantly less bleeding compared with the group treated with aspirin alone during three days. It seems that the effect of Clopidogrel on outcomes of operation is considerable and Clopidogrel can be introduced as a qualified supplement therapy for aspirin although the side effect of recombinant antiplatelet therapy is also controversial.
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Soltani et al. (2020) conducted an RCT in Off Pump Coronary Artery Bypass Graft Surgery (OPCAB) (n=413). Clopidogrel plus aspirin vs. Aspirin 80 mg alone was evaluated on Bleeding during three days (p=0.013). Clopidogrel plus aspirin resulted in significantly less bleeding compared to aspirin alone during the three days following off-pump coronary artery bypass graft surgery (P=0.013).
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