Document Detail

Benefits and risks of clopidogrel pretreatment before coronary artery bypass grafting in patients with ST-elevation myocardial infarction treated with fibrinolytics in CLARITY-TIMI 28.
MedLine Citation:
PMID:  17323134     Owner:  NLM     Status:  MEDLINE    
The Clopidogrel as Adjunctive Reperfusion Therapy-Thrombolysis in Myocardial Infarction 28 (CLARITY-TIMI 28) trial was a randomized, double-blind, placebo-controlled study of clopidogrel in 3,491 patients receiving fibrinolytic therapy for ST-segment elevation myocardial infarction. Patients were randomized to clopidogrel or placebo begun at the time of fibrinolysis. This analysis reports the outcomes among the 136 patients in the trial population who underwent coronary artery bypass grafting (CABG) during the index hospitalization. There was no difference in the rates of TIMI major or minor bleeding between the clopidogrel and placebo groups from randomization to the end of follow-up (13.6% vs. 14.3%, P = 1.0) or from the time of CABG to the end of follow-up (9.1% vs. 11.4%, P = 0.78). When any day for study medication discontinuation < or = 5 days prior to CABG was chosen as a cut point to evaluate bleeding risk for clopidogrel vs. placebo, there was no excess bleeding in the clopidogrel group. Among patients undergoing CABG, there was a trend toward reduction in the risk of cardiovascular death, recurrent MI, or recurrent ischemia requiring urgent revascularization at 30 days for those taking clopidogrel (OR 0.66, 95% CI 0.27-1.5; P = 0.37), consistent with the benefit seen in the overall trial population (OR 0.80, CI 0.65-0.97; P = 0.03). In conclusion, early clopidogrel treatment among CLARITY-TIMI 28 patients undergoing CABG was not associated with an increase in the rate of peri-operative bleeding and showed a trend toward reduction in 30-day ischemic events.
Dalton S McLean; Marc S Sabatine; Wei Guo; Carolyn H McCabe; Christopher P Cannon
Related Documents :
6509994 - Long-term results of coronary surgery.
17680184 - Sevoflurane anesthesia did not affect postoperative cognitive dysfunction in patients u...
19049724 - Does preoperative hemoglobin independently predict short-term outcomes after coronary a...
20211314 - Timing of nonemergent coronary artery bypass grafting and mortality after non-st elevat...
23523144 - Mr-guided focused ultrasound thalamotomy for essential tremor: a proof-of-concept study.
9391814 - Charcot ankle fusion with a retrograde locked intramedullary nail.
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-02-24
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  24     ISSN:  0929-5305     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-08-03     Completed Date:  2007-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  85-91     Citation Subset:  IM    
Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Coronary Artery Bypass / methods*
Double-Blind Method
Hemorrhage / chemically induced
Middle Aged
Myocardial Infarction / drug therapy,  prevention & control,  therapy*
Perioperative Care
Premedication / methods*
Risk Assessment
Thrombolytic Therapy / methods*
Ticlopidine / administration & dosage,  analogs & derivatives*
Treatment Outcome
Reg. No./Substance:
55142-85-3/Ticlopidine; 90055-48-4/clopidogrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Razaxaban, a direct factor Xa inhibitor, in combination with aspirin and/or clopidogrel improves low...
Next Document:  Prospective study of supplemental vitamin K therapy in patients on oral anticoagulants with unstable...