Mid-term Effect Of Clopidogrel And Aspirin On Graft Patency Following Coronary Artery Bypass Graft

OBJECTIVES:Prospective randomized study on comparing the effect of three groups aboutanti-platelet therapic strategies of clopidogrel plus aspirin(group AC) versusClopidogrel(group C) or aspirin(group A) alone on grafts patency after3months,1year,2years and three years after coronary artery bypass grafting (CABG).METHODS:From August2009to October2010,180patients undergoing elective OPCABwere randomly distributed into3groups, and60cases in each group according todifferrent anti-platelet therapic strategies: Group A took up aspirin (100mg) alonedaily; Group C took up clopidogrel (75mg) alone; Group AC took upclopidogrel(75mg) plus aspirin(100mg) daily. Antiplatelet therapies were givenin first24hours after operation. All participants were suggested to clinicalfollow-up at3months,1year,2years and3years after operation.64-slicemultislice computed tomography angiography (MSCTA) was used to evaluategraft patency. All the data was used for statistical analysis by SPSS17.0.RESULTS:No participants died in surgery.161/180(89.4%)participators finished3yearsfollow-up.The results of graft patency rate in3monthsIn3months follow-up post-operatively, LIMA grafts patency rate in threegroups(A, C and AC), with arithmetic method of Fitzgibbon A＋B, were96.1%, 98.1%and98.1%respectively. There were no significant differences （P＞0.05）in LIMA grafts, neither in SVGs with the patency rate of96.8%、95.8%and97.9%.The results of graft patency rate in1yearIn1year follow-up post-operatively, LIMA grafts patency rate in three groups(A,C and AC), with arithmetic method of Fitzgibbon A＋B, were94.2%,96.5%and96.3%respectively. There were no significant differences （P＞0.05）in LIMAgrafts, neither in SVGs with the patency rate of92.4%、94.7%and96.0%.The results of graft patency rate in3yearsIn3years follow-up post-operatively, LIMA grafts patency rate in three groups(A,C and AC), with arithmetic method of Fitzgibbon A＋B, were90.3%,92.7%and94.4%respectively. There were no significant differences （P＞0.05）in LIMAgrafts, neither in SVGs with the patency rate of90.3%、92.6%and93.9%.CONCLUSIONS:In3years follow-up, three anti-platelet therapeutic strategies are no significantdifferences in LIMA grafts patency (Fitzgibbon A＋B).In3years follow-up, three anti-platelet therapeutic strategies are no significantdifferences in SVG grafts patency (Fitzgibbon A＋B).We got the similar result between3years of follow-up and1years.Chlorineplus aspirin may not improve grafts patency in CABG mid-term.There is notstatistically significant in all groups, but the treatment groups with Chlorine,especially Chlorine plus aspirin, are higher than aspirin alone group in graftpatency rates. Longer efficacy is uncertain.