November 11, 2008Cardiology
Platelet-Inhibitor Drugs before and after Coronary Artery Bypass Surgery and Coronary Angioplasty: The Basis of Their Use, Data from Animal Studies, Clinical Trial Data, and Current Recommendations
Key result
Dipyridamole plus aspirin started before coronary artery bypass surgery markedly reduced vein-graft occlusion compared with placebo at a median of 1 year after operation.
Why the study?
Does platelet-inhibitor therapy initiated before coronary artery bypass surgery or coronary angioplasty reduce graft occlusion and restenosis?
Population
Patients undergoing coronary artery bypass surgery and coronary angioplasty
Comparison
Platelet-inhibitor therapy initiated before the… vs Placebo
Design
Review
Authors
Discussion
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Implication
May support pre-CABG dipyridamole-aspirin to reduce graft occlusion; leaves open efficacy before angioplasty.
Structured PICO
Does platelet-inhibitor therapy initiated before coronary artery bypass surgery or coronary angioplasty reduce graft occlusion and restenosis?
P
Population
Patients undergoing coronary artery bypass surgery and coronary angioplasty
I
Intervention
Platelet-inhibitor therapy (dipyridamole plus aspirin) initiated before the procedure
C
Comparator
Placebo
O
Outcome
Aortocoronary vein-graft occlusion and restenosissurrogate
Initiation of platelet-inhibitor therapy before coronary artery bypass surgery reduces vein-graft occlusion, while its efficacy before coronary angioplasty requires further clinical trials.
Limitations
- Results from placebo-controlled trials in humans are needed before optimal antithrombotic therapy for angioplasty can be established.
Cite This Study
Chesebro et al. (2008) conducted a review in Aortocoronary vein-graft occlusion and restenosis after coronary angioplasty. Platelet-inhibitor therapy (dipyridamole plus aspirin) vs. Placebo was evaluated on Vein-graft occlusion. Dipyridamole plus aspirin started before coronary artery bypass surgery markedly reduced vein-graft occlusion compared with placebo at a median of 1 year after operation.