Prevention of one-year vein-graft occlusion after aortocoronary-bypass surgery: a comparison of low-dose aspirin, low-dose aspirin plus dipyridamole, and oral anticoagulants. The CABADAS Research Group of the Interuniversity Cardiology Institute of The Netherlands.
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| Title: | Prevention of one-year vein-graft occlusion after aortocoronary-bypass surgery: a comparison of low-dose aspirin, low-dose aspirin plus dipyridamole, and oral anticoagulants. The CABADAS Research Group of the Interuniversity Cardiology Institute of The Netherlands. |
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| Authors: | van der Meer J (AUTHOR), Hillege HL (AUTHOR), Kootstra GJ (AUTHOR), Ascoop CAP (AUTHOR), Pfisterer M (AUTHOR), van Gilst WH (AUTHOR), Lie KI (AUTHOR), van der Meer, J (AUTHOR), Hillege, H L (AUTHOR), Kootstra, G J (AUTHOR), Ascoop, C A (AUTHOR), Mulder, B J (AUTHOR), Pfisterer, M (AUTHOR), van Gilst, W H (AUTHOR), Lie, K I (AUTHOR) |
| Source: | Lancet. 7/31/1993, Vol. 342 Issue 8866, p257-264. 8p. |
| Abstract: | Aspirin, alone or in combination with dipyridamole, is known to prevent occlusion of aortocoronary vein grafts. The benefit of dipyridamole in addition to aspirin remains controversial, and the efficacy and safety of oral anticoagulants for prevention of vein-graft occlusion have not been established. We assessed one-year angiographic vein-graft patency after aortocoronary-bypass surgery in 948 patients assigned to receive aspirin, aspirin plus dipyridamole, or oral anticoagulants in a prospective, randomised trial. The design was double-blind and placebo-controlled for the aspirin groups, but open for oral anticoagulant treatment. Dipyridamole (5 mg/kg per 24 h intravenously for 28 h, followed by 200 mg twice daily) and oral anticoagulants (desired prothrombin time range 2.8-4.8 international normalised ratio) were started before surgery, and aspirin (50 mg per day) was started after surgery. Clinical outcome was assessed by the incidence of myocardial infarction, thrombosis, major bleeding, or death. Occlusion rate of distal anastomoses was 11% in the aspirin plus dipyridamole group versus 15% in the aspirin group (relative risk 0.76, 95% CI 0.54-1.05) and 13% in the oral anticoagulants group. Clinical events occurred in 20.3% of patients receiving aspirin plus dipyridamole compared with 13.9% of the aspirin group (relative risk 1.46, 95% CI 1.02-2.08) and 16.9% of the oral anticoagulants group. Our data provide no convincing evidence that addition of dipyridamole to 50 mg aspirin per day improves aortocoronary vein-graft patency. Moreover, there is evidence that the combination increases the overall clinical-event rate. Compared with aspirin, oral anticoagulants provided no benefit. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 107472890 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Prevention of one-year vein-graft occlusion after aortocoronary-bypass surgery: a comparison of low-dose aspirin, low-dose aspirin plus dipyridamole, and oral anticoagulants. The CABADAS Research Group of the Interuniversity Cardiology Institute of The Netherlands. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22van+der+Meer+J%22">van der Meer J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hillege+HL%22">Hillege HL</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kootstra+GJ%22">Kootstra GJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ascoop+CAP%22">Ascoop CAP</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pfisterer+M%22">Pfisterer M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22van+Gilst+WH%22">van Gilst WH</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lie+KI%22">Lie KI</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22van+der+Meer%2C+J%22">van der Meer, J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hillege%2C+H+L%22">Hillege, H L</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kootstra%2C+G+J%22">Kootstra, G J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ascoop%2C+C+A%22">Ascoop, C A</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mulder%2C+B+J%22">Mulder, B J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pfisterer%2C+M%22">Pfisterer, M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22van+Gilst%2C+W+H%22">van Gilst, W H</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lie%2C+K+I%22">Lie, K I</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 7/31/1993, Vol. 342 Issue 8866, p257-264. 8p. – Name: Abstract Label: Abstract Group: Ab Data: Aspirin, alone or in combination with dipyridamole, is known to prevent occlusion of aortocoronary vein grafts. The benefit of dipyridamole in addition to aspirin remains controversial, and the efficacy and safety of oral anticoagulants for prevention of vein-graft occlusion have not been established. We assessed one-year angiographic vein-graft patency after aortocoronary-bypass surgery in 948 patients assigned to receive aspirin, aspirin plus dipyridamole, or oral anticoagulants in a prospective, randomised trial. The design was double-blind and placebo-controlled for the aspirin groups, but open for oral anticoagulant treatment. Dipyridamole (5 mg/kg per 24 h intravenously for 28 h, followed by 200 mg twice daily) and oral anticoagulants (desired prothrombin time range 2.8-4.8 international normalised ratio) were started before surgery, and aspirin (50 mg per day) was started after surgery. Clinical outcome was assessed by the incidence of myocardial infarction, thrombosis, major bleeding, or death. Occlusion rate of distal anastomoses was 11% in the aspirin plus dipyridamole group versus 15% in the aspirin group (relative risk 0.76, 95% CI 0.54-1.05) and 13% in the oral anticoagulants group. Clinical events occurred in 20.3% of patients receiving aspirin plus dipyridamole compared with 13.9% of the aspirin group (relative risk 1.46, 95% CI 1.02-2.08) and 16.9% of the oral anticoagulants group. Our data provide no convincing evidence that addition of dipyridamole to 50 mg aspirin per day improves aortocoronary vein-graft patency. Moreover, there is evidence that the combination increases the overall clinical-event rate. Compared with aspirin, oral anticoagulants provided no benefit. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 257 Titles: – TitleFull: Prevention of one-year vein-graft occlusion after aortocoronary-bypass surgery: a comparison of low-dose aspirin, low-dose aspirin plus dipyridamole, and oral anticoagulants. The CABADAS Research Group of the Interuniversity Cardiology Institute of The Netherlands. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: van der Meer J – PersonEntity: Name: NameFull: Hillege HL – PersonEntity: Name: NameFull: Kootstra GJ – PersonEntity: Name: NameFull: Ascoop CAP – PersonEntity: Name: NameFull: Pfisterer M – PersonEntity: Name: NameFull: van Gilst WH – PersonEntity: Name: NameFull: Lie KI – PersonEntity: Name: NameFull: van der Meer, J – PersonEntity: Name: NameFull: Hillege, H L – PersonEntity: Name: NameFull: Kootstra, G J – PersonEntity: Name: NameFull: Ascoop, C A – PersonEntity: Name: NameFull: Mulder, B J – PersonEntity: Name: NameFull: Pfisterer, M – PersonEntity: Name: NameFull: van Gilst, W H – PersonEntity: Name: NameFull: Lie, K I IsPartOfRelationships: – BibEntity: Dates: – D: 31 M: 07 Text: 7/31/1993 Type: published Y: 1993 Identifiers: – Type: issn-print Value: 01406736 Numbering: – Type: volume Value: 342 – Type: issue Value: 8866 Titles: – TitleFull: Lancet Type: main |
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