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Dual platelet antiaggregation therapy after myocardial revascularization surgery. | LitMetric

AI Article Synopsis

  • - CABG is an effective treatment for CAD, helping to manage symptoms and improve patients' long-term health, but the success rate of venous grafts is often hindered by a high chance of occlusion immediately after surgery and in the following years.
  • - Aspirin is commonly used after CABG, while clopidogrel was traditionally reserved for those allergic to aspirin, but new research suggests that using both (dual anti-platelet therapy or DAPT) may lower mortality rates and cardiovascular issues for CABG patients.
  • - Despite potential benefits of DAPT, there isn't enough randomized research to clear up disagreements between European and American cardiology guidelines, leading to confusion in treatment approaches for CABG patients.

Article Abstract

Coronary artery bypass graft (CABG) is a consolidated treatment in patients with coronary artery disease (CAD) for both symptom control and improvement of prognosis. The patency of venous grafts is still the most vulnerable point of the surgical treatment since it presents a high prevalence of occlusion both in the immediate postoperative period and in the long-term follow-up. Aspirin plays a well-established role in this setting, and for a long time, clopidogrel use has been restricted to patients allergic to aspirin. Recently, subgroup analyses of studies with different anti-platelet therapies have shown reduced mortality and cardiovascular events in patients on dual anti-platelet antiplatelet therapy (DAPT) undergoing CABG, although such studies have not been designed to evaluate this patient profile. However, there is still an insufficient number of randomized studies using DAPT in this context, resulting in a disagreement between the European and American cardiology societies guidelines regarding their indication and generating doubts in clinical practice.

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Source
http://dx.doi.org/10.1590/1806-9282.65.3.316DOI Listing

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