Ticagrelor versus aspirin and vein graft patency after coronary bypass: A randomized trial

2021 ◽  
Author(s):  
Alexander Kulik ◽  
Amy M. Abreu ◽  
Viviana Boronat ◽  
Nicholas T. Kouchoukos ◽  
Marc Ruel
Keyword(s):  
Randomized Trial ◽  
Vein Graft ◽  
Coronary Bypass ◽  
Graft Patency

Oral Anticoagulation in the Prevention of One-Year Vein Graft Occlusion after Aortocoronary Bypass Surgery: Optimal Therapeutic Range and Practical Limitations

1994 ◽  
Vol 72 (05) ◽  
pp. 676-681 ◽  
Author(s):  
J van der Meer ◽  
H L Hillege ◽  
P H J M Dunselman ◽  
B J M Mulder ◽  
H R Michels ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Major Bleeding ◽  
Oral Anticoagulation ◽  
Vein Graft ◽  
Oral Anticoagulant Therapy ◽  
Coronary Bypass ◽  
Graft Patency ◽  
Graft Occlusion ◽  
Coronary Bypass Grafts ◽  
One Year

SummaryTo assess the optimal level of oral anticoagulation to prevent occlusion of vein coronary bypass grafts, 318 patients from a graft patency trial were analysed retrospectively. Oral anticoagulant therapy was started one day before surgery and continued for one year, after which graft occlusion was assessed by angiography. The aimed level of anticoagulation was 2.8-1.8 International Normalized Ratio (INR). Clinical outcome was assessed by the incidence of myocardial infarction, thrombosis and major bleeding.The observed anticoagulation level was 2.8-4.8 INR for 54%, and 1.8-3.8 INR for 75% of time per patient. Occlusion rates in patients who spent <35, 35-70, and ≥70% of time within INR range 2.8-1.8 were 10.5%, 10.8% and 11.8%, respectively (differences not statistically significant). Patients who spent ≥70% of time within INR range 1.8-3.8 versus 2.8-4.8 showed comparable occlusion rates. The risk of graft occlusion was not related to quality of anticoagulation early (0-3 months) or late (3-12 months) after surgery. Myocardial infarction, thrombosis and major bleeding occurred in 1.3%, 2.0% and 2.9% of patients.To maintain vein graft patency in the first postoperative year by oral anticoagulation, a level within INR range 1.8-3.8 for ≥70% of time seems to be sufficient.

scholarly journals Graft patency at 3 months after off- and on-pump coronary bypass surgery: a randomized trial

2019 ◽  
Vol 36 (2) ◽  
pp. 93-104 ◽  
Author(s):  
Lokeswara Rao Sajja ◽  
Kunal Sarkar ◽  
Gopichand Mannam ◽  
Venkata Krishna Kumar Kodali ◽  
Chandrasekar Padmanabhan ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Randomized Trial ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Graft Patency ◽  
Conventional Coronary Angiography ◽  
Off Pump ◽  
Significant Difference ◽  
Pump Cabg

Abstract Purpose Coronary artery bypass grafting (CABG) is performed either with the aid of cardiopulmonary bypass (on-pump) or without cardiopulmonary bypass (off-pump). There is a scarcity of angiographic data to support the non-inferiority of off-pump technique to on-pump technique. The objective of this study is to ascertain the non-inferiority of off-pump CABG when compared to on-pump CABG in terms of angiographically assessed graft patency at 3 months. Methods A total of 320 patients with multivessel coronary artery disease were enrolled in a multicenter prospective randomized trial either to on-pump CABG (n = 162) or off-pump CABG (n = 158) between March 2016 through March 2017. Graft patency was evaluated by using either multidetector computerized tomographic angiography or conventional coronary angiography at 3 months. The major adverse cardiac and cardiovascular events (MACCE) were also analyzed at 3 months. Results The median number of grafts per patient in off-pump was 3.00 (Q1:3.00 and Q3:4.00) vs on-pump 4.00 (Q1:3.00 to Q3:4.00), and the mean number of grafts per patient was lower in the off-pump CABG at 3.45 ± 0.75 vs 3.64 ± 0.70 in the on-pump CABG (p = 0.01). There was no significant difference in mortality at 3 months between the off-pump (0.63%) and on-pump groups (1.85%) with p value of 0.62. The cumulative combined MACCE showed significant difference between off-pump group (0.63%) and on-pump group (5.55%), p = 0.01. Follow-up angiograms were done in 239 (75%) patients with 120 off-pump and 119 in the on-pump group. The analysis was also done regarding graft patency in a graded manner—when analysis of A (excellent) grafts vs B (stenosed) grafts and O (occluded) grafts were made, there was no statistically significant difference in overall graft patency at 3 months between on-pump [376 /429 grafts (87.6%)] and off-pump [366 /420 grafts (87.1%)] groups (p = 0.82). The patency rates were similar among bypass conduits (left internal thoracic artery (ITA) in off-pump (91.4%) vs on-pump (92.9%) p = 0.66, right ITA in off-pump (82.1%) vs on-pump (81.8%) p = 0.97, radial artery in off-pump (84.4%) vs on-pump (82.6%) p = 0.81; saphenous vein in off-pump (85.8%) vs on-pump (86.3%), p = 0.86 and among 3 coronary territories. Conclusions Off-pump CABG is non-inferior to on-pump CABG in terms of overall graft patency at 3 months and was associated with a fewer combined cumulative MACCE compared to on-pump CABG.

Effect of Dipyridamole and Aspirin on Late Vein-Graft Patency after Coronary Bypass Operations

1984 ◽  
Vol 310 (4) ◽  
pp. 209-214 ◽  
Author(s):  
James H. Chesebro ◽  
Valentin Fuster ◽  
Lila R. Elveback ◽  
Ian P. Clements ◽  
Hugh C. Smith ◽  
...  
Keyword(s):  
Vein Graft ◽  
Coronary Bypass ◽  
Graft Patency

Statin Therapy and Saphenous Vein Graft Disease After Coronary Bypass Surgery: Analysis From the CASCADE Randomized Trial

2011 ◽  
Vol 92 (4) ◽  
pp. 1284-1291 ◽  
Author(s):  
Alexander Kulik ◽  
Pierre Voisine ◽  
Patrick Mathieu ◽  
Roy G. Masters ◽  
Thierry G. Mesana ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Statin Therapy ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Bypass Surgery ◽  
Saphenous Vein Graft ◽  
Coronary Bypass ◽  
Vein Graft Disease ◽  
Graft Disease ◽  
Saphenous Vein Graft Disease

scholarly journals Predictors of saphenous vein graft patency: A risk assessment based on a longitudinal analysis of 100 consecutive post-coronary bypass angiographic studies

2003 ◽  
Vol 41 (6) ◽  
pp. 499
Author(s):  
Todd K. Rosengart ◽  
Eileen B. Finnin ◽  
Stacie A. Hudgens ◽  
Elizabeth A. Hahn ◽  
Ronald D. Curran ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Longitudinal Analysis ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Coronary Bypass ◽  
Graft Patency

scholarly journals Aprotinin for coronary bypass operations: Efficacy, safety, and influence on early saphenous vein graft patency

1994 ◽  
Vol 107 (2) ◽  
pp. 543-553 ◽  
Author(s):  
John H. Lemmer ◽  
William Stanford ◽  
Sharon L. Bonney ◽  
Jerome F. Breen ◽  
Eva V. Chomka ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Coronary Bypass ◽  
Graft Patency
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