Circulation, Vol 89, 1138-1143, Copyright © 1994 by American Heart Association
S Goldman, J Copeland, T Moritz, W Henderson, K Zadina, T Ovitt, KB Kern, G Sethi, GV Sharma and S Khuri
BACKGROUND: The long-term success of coronary bypass surgery is dependent
on graft patency after surgery. This trial was designed to determine if
aspirin improved saphenous vein graft or internal mammary artery (IMA)
graft patency between 1 and 3 years after coronary artery bypass grafting
(CABG). METHODS AND RESULTS: After receiving aspirin 325 mg/d for 1 year
after CABG and undergoing a 1-year postoperative cardiac catheterization,
patients were randomized to receive either aspirin (325 mg) or placebo for
2 additional years. Angiography was performed 3 years after surgery to
determine the primary end point- saphenous vein graft patency in 288
patients and IMA graft patency in 167 patients. At 3 years after CABG, the
saphenous vein graft occlusion rate was 17.0% (62 of 365) for patients
treated with aspirin compared with 19.7% (74 of 376) for those who received
placebo (P = .404). For saphenous vein grafts that were patent at 1 year,
the occlusion rate at 3 years was 4.8% (15 of 313) for patients treated
with aspirin compared with 4.2% (13 of 310) for patients who received
placebo (P = .757). At 3 years, the IMA graft occlusion rate was 10.3% (8
of 78) for patients treated with aspirin compared with 7.9% (7 of 89) for
patients who received placebo (P = .594). For IMA grafts that were patent
at 1 year, the occlusion rate was 4.3% (3 of 70) for patients treated with
aspirin compared with 2.5% (2 of 81) for patients who received placebo (P =
.541). CONCLUSIONS: These data suggest that aspirin treatment does not
improve saphenous vein graft or IMA graft patency between 1 and 3 years
after CABG.
ARTICLES
Long-term graft patency (3 years) after coronary artery surgery. Effects of aspirin: results of a VA Cooperative study
VA Medical Center, Tucson, AZ.
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