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Long-term effect of dual antiplatelet treatment after off-pump coronary artery bypass grafting.
MedLine Citation:
PMID:  23879339     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: Recent studies have found increased long-term cardiovascular morbidity after off-pump coronary artery bypass surgery (OPCAB). We evaluated the efficacy and safety of dual antiplatelet therapy (DAT) in the prevention of cardiovascular events at two years after OPCAB surgery.
METHODS: Retrospective study that included all patients that underwent OPCAB surgery in our institution between 2009 and 2010. Single or dual antiplatelet therapy was initiated at hospital discharge, and its effect in patients' prognosis was analyzed. Follow-up was conducted by telephone and using the hospital databases. The primary end-point was the composite of acute coronary syndrome (ACS), revascularization, stroke, or cardiovascular death.
RESULTS: The study included 237 patients divided into: (A) 128 patients who received single antiplatelet therapy and (B) 109 patients who received dual antiplatelet therapy. The mean follow-up was 23.85 months (standard deviation 0.5 months). 13.9% of patients had a primary end-point event. Patients in group A had a higher event rate compared with group B (18.8% vs. 8.3%, p = 0.02), with a significant reduction in hospital readmissions for ACS (10.9% vs. 3.7%, p = 0.035). In the multivariate analysis, dual antiplatelet therapy was an independent protective factor in the occurrence of events (hazard ratio = 0.395, 95% CI, 0.176 to 0.885, p = 0.024). There were no significant differences between the two groups with respect to bleeding events.
CONCLUSION: Dual antiplatelet therapy after OPCAB surgery is associated with a decrease in the appearance of new cardiovascular events, due to a reduction in the number of hospital readmissions for ACS. doi: 10.1111/jocs.12144 (J Card Surg 2013;28:366-372).
José López; Carlos Morales; Pablo Avanzas; Francisco Callejo; Daniel Hernández-Vaquero; Juan C Llosa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  28     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  366-72     Citation Subset:  IM    
Copyright Information:
© 2013 Wiley Periodicals, Inc.
Department of Cardiac Surgery, University Central Hospital of Asturias, Oviedo, Asturias, Spain.
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