Early Antiplatelet Therapy in Coronary Artery Bypass Grafting a Calculated Benefit

2010 ◽  
Vol 5 (5) ◽  
pp. 317-325 ◽  
Author(s):  
Gregory D. Trachiotis
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Antiplatelet Therapy ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Bypass Grafting ◽  
Platelet Activity ◽  
Artery Bypass Grafting ◽  
Increased Risk

Studies have demonstrated that antagonists of platelet activity, including aspirin and clopidogrel, reduce the risk of major adverse events in patients with acute coronary syndromes. Although antiplatelet agents also convey an increased risk of bleeding, particularly in patients proceeding to coronary artery bypass graft surgery, in most cases, the benefits of early initiation of antiplatelet therapy outweigh the risks. The purpose of this review is to distinguish perceived and actual risk versus the benefit associated with early antiplatelet therapy to help clinicians make informed decisions on using these agents in an acute setting where patients may require coronary artery bypass grafting.

Platelet activity before and after coronary artery bypass grafting

Platelets ◽  
2006 ◽  
Vol 17 (5) ◽  
pp. 289-291 ◽  
Author(s):  
Gennadi Kobzar ◽  
Vilja Mardla ◽  
Indrek Rätsep ◽  
Nigulas Samel
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Platelet Activity ◽  
Artery Bypass Grafting ◽  
Before And After

scholarly journals Antiplatelet therapy and coronary artery bypass grafting

Medicine ◽  
2019 ◽  
Vol 98 (34) ◽  
pp. e16880 ◽  
Author(s):  
Saurabh Gupta ◽  
Emilie P. Belley-Côté ◽  
Bram Rochwerg ◽  
Anthony Bozzo ◽  
Puru Panchal ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Antiplatelet Therapy ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

EFFECT OF ANTIPLATELET THERAPY ON EARLY GRAFT PATENCY AFTER CORONARY ARTERY BYPASS GRAFTING: VA COOPERATIVE STUDY # 207

1987 ◽  
Author(s):  
S Goldman ◽  
J Copeland ◽  
T Moritz ◽  
W Henderson ◽  
L A Harker
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Antiplatelet Therapy ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Graft Patency ◽  
Reoperation Rate ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Early Graft

To determine if specific antiplatelet therapy improved graft patency after coronary artery bypass grafting (CABG) -we compared (1) aspirin(325 mg qd), (2)aspirin(325 mg tid),(3) aspirin and dipyridamole(325 mg and 75 mg resp.tid), (4) sulfinpyrazone(267 mg tid) and (5) placebo(tid).Therapy was started 48 hours before CABGexcept for aspirin. When aspirin was a treatment,one 325 mg dose was given12 hours before surgery. Graft patency data were obtained early, one week, and then later, one year, after surgery. Preliminarydata, based on local interpretation of the angiograms at each center, in the firs 496 patients (1711 grafts), revealed thefollowing early graft patencies: aspiri qd (93%), aspirin tid (93%), aspirin and dipyridamole (93%),and sulfinpyrazone (92%). All these therapies improved(P<0.005)early graft patency compared to placebo (84%). Chest tube drainage measured within the first 35 hours after CABG revealed that the median loss with aspirintid (1114 ml) and aspirin and dipyridamole (972 ml) exceeded (P<0.001) placebo (802 ml) while aspirinqd (880 ml) and sulfinpyrazone (750 ml) did not. The reoperation rate was greater(P<0.01) in all the treatment groups thatcontained aspirin (6.1%) compared to the two non aspirin groups (1.9%). Overall operative mortality was 2.1%. In conclusion, graft patency was improved early after CABG with antiplatelet therapy. Two regimens which included preoperative aspirin has increased blood loss after CABG and preoperative aspirin increased the reoperation rate.

Postoperative depression in patients after coronary artery bypass grafting (CABG) – a review of the literature

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Paweł Stanicki ◽  
Julita Szarpak ◽  
Małgorzata Wieteska ◽  
Agnieszka Kaczyńska ◽  
Joanna Milanowska
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Response To Treatment ◽  
Bypass Grafting ◽  
Negative Consequences ◽  
Oxidative Stress Biomarkers ◽  
Artery Bypass Grafting ◽  
Increased Risk

<b>Introduction:</b> Ischemic heart disease is the most common cause of death in the world. The lives of patients with vascular defects can be saved by coronary artery bypass grafting (CABG). However, it is associated with an increased risk of developing depression after surgery. <br><b>Meterial and Methods:</b> The aim of the study is to present the results of the latest research on postoperative depression after CABG, including studies describing the course of the disease, its consequences for the patient’s prognosis and treatment. The publications available on the PubMed platform published after 2011 were reviewed. <br><b>Results:</b> Depression before and after CABG affects 30–40% of patients, mostly women. Established after surgery and untreated, it persists for many years. The level of anxiety in patients decreases systematically after surgery. Indicators that may correlate with the patient’s postoperative depression, including cortisol, high sensitivity C-reactive protein (hsCRP) and oxidative stress biomarkers, are being investigated. The occurrence of depression in patients after CABG has a number of negative consequences. Those include: weaker response to treatment, greater chance of relapse, and increased readmission frequency and mortality. Treatment of patients with this disorder involves the use of antidepressants (most often SSRIs – selective serotonin reuptake inhibitor) and/or various types of psychotherapy with cognitive behavioral therapy (CBT) at the forefront. <br><b>Conclusions:</b> Depression following CABG decreases the quality of life and worsens patient prognosis. It is necessary to detect this condition early after surgery and to apply treatment, taking into account the cardiological disorders of the patient.

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