CLINICAL STUDY: ANTIPLATELET THERAPY
The effect of clopidogrel incombination with aspirin whengiven before coronary artery bypass grafting
Richard H. Hongo, MD*,
Jill Ley, RN, MS, CCRN*,
Stuart E. Dick, MPH, RD* and
Rupsa R. Yee, MD, FACC*,*
* Division of Cardiology, California Pacific Medical Center, San Francisco, California, USA
Manuscript received November 20, 2001;
revised manuscript received April 8, 2002,
accepted April 18, 2002.
* Reprint requests and correspondence: Dr. Rupsa R. Yee, Division of Cardiology, California Pacific Medical Center, 2333 Buchanan Street, San Francisco, California 94115, USA.
phillimx{at}sutterhealth.org
OBJECTIVES: This study was designed to evaluate the effect of preoperative clopidogrel on coronary artery bypass graft surgery (CABG) outcomes.
BACKGROUND: Clopidogrel in combination with aspirin, given before percutaneous coronary intervention, has become the standard for stent thrombosis prevention. Some premedicated patients, however, are found to have surgical disease on angiography, and irreversible platelet inhibition becomes a concern for upcoming CABG.
METHODS: We prospectively studied 224 consecutive patients undergoing nonemergent first-time CABG, and compared those with preoperative clopidogrel exposure within seven days (n = 59) to those without exposure (n = 165).
RESULTS: The groups were comparable in age, gender, body surface area, preoperative hematocrit, preoperative prothrombin time and prior myocardial infarction. The clopidogrel group had higher 24-h mean chest tube output (1,224 ml vs. 840 ml, p = 0.001), and more transfusions of red blood cells (2.51 U vs. 1.74 U, p = 0.036), platelets (0.86 U vs. 0.24 U, p = 0.001) and fresh frozen plasma (0.68 U vs. 0.24 U, p = 0.015). Moreover, reoperation for bleeding was 10-fold higher in the clopidogrel group (6.8% vs. 0.6%, p = 0.018). The clopidogrel group also had less extubation within 8 h (54.2% vs. 75.8%, p = 0.002) and a trend towards less hospital discharge within five days (33.9% vs. 46.7%, p = 0.094).
CONCLUSIONS: Clopidogrel in combination with aspirin before CABG is associated with higher postoperative bleeding and morbidity. These findings raise concern regarding the routine administration of clopidogrel before anticipated coronary stent implantation.
|
Abbreviations and Acronyms
| | ADP | | adenosine diphosphate | | CABG | | coronary artery bypass graft surgery | | CLASSICS | | Clopidogrel Aspirin Stent International Cooperative Study | | CURE | | Clopidogrel in Unstable Angina to Prevent Recurrent Ischemic Events trial | | GP | | glycoprotein |
|
This article has been cited by other articles:
|
|
|
|
 
American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society for Vascular Medicine, Society for Vascular Surgery, L. A. Fleisher, et al.
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
J. Am. Coll. Cardiol.,
November 24, 2009;
54(22):
e13 - e118.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. E. Firanescu, E. J. Martens, J. P.A.M. Schonberger, M. A. Soliman Hamad, and A. H.M. van Straten
Postoperative blood loss in patients undergoing coronary artery bypass surgery after preoperative treatment with clopidogrel. A prospective randomised controlled study
Eur. J. Cardiothorac. Surg.,
November 1, 2009;
36(5):
856 - 862.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. F. Aranki and S. C. Body
Antiplatelet agents used for early intervention in acute coronary syndrome: Myocardial salvage versus bleeding complications.
J. Thorac. Cardiovasc. Surg.,
October 1, 2009;
138(4):
807 - 810.e7.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Napenas, C. H.L. Hong, M. T. Brennan, S. L. Furney, P. C. Fox, and P. B. Lockhart
The Frequency of Bleeding Complications After Invasive Dental Treatment in Patients Receiving Single and Dual Antiplatelet Therapy
J Am Dent Assoc,
June 1, 2009;
140(6):
690 - 695.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Velik-Salchner, S. Maier, P. Innerhofer, C. Kolbitsch, W. Streif, M. Mittermayr, M. Praxmarer, and D. Fries
An Assessment of Cardiopulmonary Bypass-Induced Changes in Platelet Function Using Whole Blood and Classical Light Transmission Aggregometry: The Results of a Pilot Study
Anesth. Analg.,
June 1, 2009;
108(6):
1747 - 1754.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Ebrahimi, C. Dyke, R. Mehran, S. V. Manoukian, F. Feit, D. A. Cox, B. J. Gersh, E. M. Ohman, H. D. White, J. W. Moses, et al.
Outcomes following pre-operative clopidogrel administration in patients with acute coronary syndromes undergoing coronary artery bypass surgery: the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial.
J. Am. Coll. Cardiol.,
May 26, 2009;
53(21):
1965 - 1972.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Smout and G. Stansby
Surgery and antiplatelet agents: what are the risks?
Clin Risk,
May 1, 2009;
15(3):
101 - 105.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Blasco-Colmenares, T. M. Perl, E. Guallar, W. A. Baumgartner, J. V. Conte, D. Alejo, R. Pastor-Barriuso, A. R. Sharrett, and N. Faraday
Aspirin Plus Clopidogrel and Risk of Infection After Coronary Artery Bypass Surgery
Arch Intern Med,
April 27, 2009;
169(8):
788 - 795.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. C. Collyer, D. J. Gray, R. Sandhu, J. Berridge, and G. Lyons
Assessment of platelet inhibition secondary to clopidogrel and aspirin therapy in preoperative acute surgical patients measured by Thrombelastography(R) Platelet MappingTM
Br. J. Anaesth.,
April 1, 2009;
102(4):
492 - 498.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. N. Vaccarino, J. Thierer, M. Albertal, M. Vrancic, F. Piccinini, M. Benzadon, H. Raich, and D. O. Navia
Impact of preoperative clopidogrel in off pump coronary artery bypass surgery: a propensity score analysis.
J. Thorac. Cardiovasc. Surg.,
February 1, 2009;
137(2):
309 - 313.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Velik-Salchner, S. Maier, P. Innerhofer, W. Streif, A. Klingler, C. Kolbitsch, and D. Fries
Point-of-Care Whole Blood Impedance Aggregometry Versus Classical Light Transmission Aggregometry for Detecting Aspirin and Clopidogrel: The Results of a Pilot Study
Anesth. Analg.,
December 1, 2008;
107(6):
1798 - 1806.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Cattaneo
Advances in antiplatelet therapy: overview of new P2Y12 receptor antagonists in development
Eur. Heart J. Suppl.,
November 1, 2008;
10(suppl_I):
I33 - I37.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Gumina, E. H. Yang, G. S. Sandhu, A. Prasad, J. F. Bresnahan, R. J. Lennon, C. S. Rihal, D. R. Holmes Jr, and M. Singh
Survival Benefit With Concomitant Clopidogrel and Glycoprotein IIb/IIIa Inhibitor Therapy at Ad Hoc Percutaneous Coronary Intervention
Mayo Clin. Proc.,
September 1, 2008;
83(9):
995 - 1001.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Suwalski, P. Suwalski, K. J. Filipiak, M. Postula, F. Majstrak, and G. Opolski
The effect of off-pump coronary artery bypass grafting on platelet activation in patients on aspirin therapy until surgery day.
Eur. J. Cardiothorac. Surg.,
August 1, 2008;
34(2):
365 - 369.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Lindvall, U. Sartipy, T. Ivert, and J. van der Linden
Aprotinin is Not Associated With Postoperative Renal Impairment After Primary Coronary Surgery
Ann. Thorac. Surg.,
July 1, 2008;
86(1):
13 - 19.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Dunning, M. Versteegh, A. Fabbri, A. Pavie, P. Kolh, U. Lockowandt, S. A.M. Nashef, and on behalf of the EACTS Audit and Guidelines Commit
Guideline on antiplatelet and anticoagulation management in cardiac surgery.
Eur. J. Cardiothorac. Surg.,
July 1, 2008;
34(1):
73 - 92.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Maltais, L. P. Perrault, and Q.-B. Do
Effect of clopidogrel on bleeding and transfusions after off-pump coronary artery bypass graft surgery: impact of discontinuation prior to surgery.
Eur. J. Cardiothorac. Surg.,
July 1, 2008;
34(1):
127 - 131.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. D. Douketis, P. B. Berger, A. S. Dunn, A. K. Jaffer, A. C. Spyropoulos, R. C. Becker, and J. Ansell
The Perioperative Management of Antithrombotic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
299S - 339S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. C. Becker
Emerging constructs to maintain safety among patients with acute coronary syndromes requiring surgical coronary revascularization
Eur. Heart J. Suppl.,
May 1, 2008;
10(suppl_D):
D12 - D22.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. H. Levy, K. A. Tanaka, and J. M. Bailey
Cardiac Surgical Pharmacology
Card. Surg. Adult,
January 1, 2008;
3(2008):
77 - 110.
[Full Text]
|
|
|
|
|
|
|
I. George and M. C. Oz
Myocardial Revascularization after Acute Myocardial Infarction
Card. Surg. Adult,
January 1, 2008;
3(2008):
669 - 696.
[Full Text]
|
|
|
|
|
|
|
A. K. Gitt and A. Betriu
Antiplatelet therapy in acute coronary syndromes
Eur. Heart J. Suppl.,
January 1, 2008;
10(suppl_A):
A4 - A12.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al.
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery
J. Am. Coll. Cardiol.,
October 23, 2007;
50(17):
e159 - e242.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al.
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Circulation,
October 23, 2007;
116(17):
e418 - e500.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Andreasen, M. Westen, P. A. Pallesen, S. Jensen, A. Gorst-Rasmussen, and S. P. Johnsen
Transfusion practice in coronary artery bypass surgery in Denmark: a multicenter audit
Interactive CardioVascular and Thoracic Surgery,
October 1, 2007;
6(5):
623 - 627.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. K. Shim, Y. S. Choi, Y. J. Oh, S. O. Bang, K. J. Yoo, and Y. L. Kwak
Effects of preoperative aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in patients undergoing off-pump coronary artery bypass graft surgery
J. Thorac. Cardiovasc. Surg.,
July 1, 2007;
134(1):
59 - 64.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. S. DeLoach and E. R. Mohler III
Peripheral Arterial Disease: A Guide for Nephrologists
Clin. J. Am. Soc. Nephrol.,
July 1, 2007;
2(4):
839 - 846.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
The Society of Thoracic Surgeons Blood Conservatio, V. A. Ferraris, S. P. Ferraris, S. P. Saha, E. A. Hessel II, C. K. Haan, B. D. Royston, C. R. Bridges, R. S.D. Higgins, G. Despotis, et al.
Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline
Ann. Thorac. Surg.,
May 1, 2007;
83(5_Supplement):
S27 - S86.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Ouattara, H. Bouzguenda, Y. Le Manach, P. Leger, A. Mercadier, P. Leprince, N. Bonnet, G. Montalescot, B. Riou, and P. Coriat
Impact of aspirin with or without clopidogrel on postoperative bleeding and blood transfusion in coronary surgical patients treated prophylactically with a low-dose of aprotinin
Eur. Heart J.,
April 12, 2007;
(2007)
ehm049v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Kunadian, A. R. Thornley, M. Tanos, and J. Dunning
Should clopidogrel be stopped prior to urgent cardiac surgery?
Interactive CardioVascular and Thoracic Surgery,
October 1, 2006;
5(5):
630 - 636.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. H. Mehta, M. T. Roe, J. Mulgund, E. M. Ohman, C. P. Cannon, W. B. Gibler, C. V. Pollack Jr, S. C. Smith Jr, T. B. Ferguson, and E. D. Peterson
Acute Clopidogrel Use and Outcomes in Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Coronary Artery Bypass Surgery
J. Am. Coll. Cardiol.,
July 18, 2006;
48(2):
281 - 286.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Bavry and A. M. Lincoff
Is Clopidogrel Cardiovascular Medicine's Double-Edged Sword?
Circulation,
April 4, 2006;
113(13):
1638 - 1640.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. I. Kapetanakis, D. A. Medlam, K. R. Petro, E. Haile, P. C. Hill, M. K.C. Dullum, A. S. Bafi, S. W. Boyce, and P. J. Corso
Effect of Clopidogrel Premedication in Off-Pump Cardiac Surgery: Are We Forfeiting the Benefits of Reduced Hemorrhagic Sequelae?
Circulation,
April 4, 2006;
113(13):
1667 - 1674.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Borgdorff and G. J. Tangelder
Pump-induced platelet aggregation with subsequent hypotension: Its mechanism and prevention with clopidogrel
J. Thorac. Cardiovasc. Surg.,
April 1, 2006;
131(4):
813 - 821.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Ernst, R. Eberhardt, M. Wahidi, H. D. Becker, and F. J. F. Herth
Effect of Routine Clopidogrel Use on Bleeding Complications After Transbronchial Biopsy in Humans
Chest,
March 1, 2006;
129(3):
734 - 737.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. S. Poston, C. White, J. Gu, J. Brown, J. Gammie, R. N. Pierson, A. Lee, I. Connerney, T. Avari, R. Christenson, et al.
Aprotinin Shows Both Hemostatic and Antithrombotic Effects During Off-Pump Coronary Artery Bypass Grafting
Ann. Thorac. Surg.,
January 1, 2006;
81(1):
104 - 111.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Lindvall, U. Sartipy, and J. van der Linden
Aprotinin Reduces Bleeding and Blood Product Use in Patients Treated With Clopidogrel Before Coronary Artery Bypass Grafting
Ann. Thorac. Surg.,
September 1, 2005;
80(3):
922 - 927.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-Y. Leong, R. A. Baker, P. J. Shah, V. K. Cherian, and J. L. Knight
Clopidogrel and Bleeding After Coronary Artery Bypass Graft Surgery
Ann. Thorac. Surg.,
September 1, 2005;
80(3):
928 - 933.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S J Walsh, M S Spence, D Crossman, and A A J Adgey
Clopidogrel in non-ST segment elevation acute coronary syndromes: an overview of the submission by the British Cardiac Society and the Royal College of Physicians of London to the National Institute for Clinical Excellence, and beyond
Heart,
September 1, 2005;
91(9):
1135 - 1140.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. van der Linden, G. Lindvall, and U. Sartipy
Aprotinin Decreases Postoperative Bleeding and Number of Transfusions in Patients on Clopidogrel Undergoing Coronary Artery Bypass Graft Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial
Circulation,
August 30, 2005;
112(9_suppl):
I-276 - I-280.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A. Bybee, B. D. Powell, U. Valeti, A. G. Rosales, S. L. Kopecky, C. Mullany, and R. S. Wright
Preoperative Aspirin Therapy Is Associated With Improved Postoperative Outcomes in Patients Undergoing Coronary Artery Bypass Grafting
Circulation,
August 30, 2005;
112(9_suppl):
I-286 - I-292.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. P. Cannon, S. R. Mehta, and S. F. Aranki
Balancing the Benefit and Risk of Oral Antiplatelet Agents in Coronary Artery Bypass Surgery
Ann. Thorac. Surg.,
August 1, 2005;
80(2):
768 - 779.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Akowuah, V. Shrivastava, B. Jamnadas, D. Hopkinson, P. Sarkar, R. Storey, P. Braidley, and G. Cooper
Comparison of Two Strategies for the Management of Antiplatelet Therapy During Urgent Surgery
Ann. Thorac. Surg.,
July 1, 2005;
80(1):
149 - 152.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. D. Wiviott, E. M. Antman, K. J. Winters, G. Weerakkody, S. A. Murphy, B. D. Behounek, R. J. Carney, C. Lazzam, R. G. McKay, C. H. McCabe, et al.
Randomized Comparison of Prasugrel (CS-747, LY640315), a Novel Thienopyridine P2Y12 Antagonist, With Clopidogrel in Percutaneous Coronary Intervention: Results of the Joint Utilization of Medications to Block Platelets Optimally (JUMBO)-TIMI 26 Trial
Circulation,
June 28, 2005;
111(25):
3366 - 3373.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Ascione, A. Ghosh, C. A. Rogers, A. Cohen, C. Monk, and G. D. Angelini
In-Hospital Patients Exposed to Clopidogrel Before Coronary Artery Bypass Graft Surgery: A Word of Caution
Ann. Thorac. Surg.,
April 1, 2005;
79(4):
1210 - 1216.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. A. Gurbel, K. P. Bliden, K. A. Zaman, J. A. Yoho, K. M. Hayes, and U. S. Tantry
Clopidogrel Loading With Eptifibatide to Arrest the Reactivity of Platelets: Results of the Clopidogrel Loading With Eptifibatide to Arrest the Reactivity of Platelets (CLEAR PLATELETS) Study
Circulation,
March 8, 2005;
111(9):
1153 - 1159.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. I. Kapetanakis, D. A. Medlam, S. W. Boyce, E. Haile, P. C. Hill, M. K.C. Dullum, A. S. Bafi, K. R. Petro, and P. J. Corso
Clopidogrel administration prior to coronary artery bypass grafting surgery: the cardiologist's panacea or the surgeon's headache?
Eur. Heart J.,
March 2, 2005;
26(6):
576 - 583.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Shander, D. Moskowitz, and T. S. Rijhwani
The Safety and Efficacy of "Bloodless" Cardiac Surgery
Seminars in Cardiothoracic and Vascular Anesthesia,
March 1, 2005;
9(1):
53 - 63.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. M. Wahidi, R. Garland, D. Feller-Kopman, F. Herth, H. D. Becker, and A. Ernst
Effect of Clopidogrel With and Without Aspirin on Bleeding Following Transbronchial Lung Biopsy
Chest,
March 1, 2005;
127(3):
961 - 964.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. J. Lansky, J. S. Hochman, P. A. Ward, G. S. Mintz, R. Fabunmi, P. B. Berger, G. New, C. L. Grines, C. G. Pietras, M. J. Kern, et al.
Percutaneous Coronary Intervention and Adjunctive Pharmacotherapy in Women: A Statement for Healthcare Professionals From the American Heart Association
Circulation,
February 22, 2005;
111(7):
940 - 953.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. J. Gluckman, M. Sachdev, S. P. Schulman, and R. S. Blumenthal
A Simplified Approach to the Management of Non-ST-Segment Elevation Acute Coronary Syndromes
JAMA,
January 19, 2005;
293(3):
349 - 357.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Garcia, M. J. Canoniero, J. A. Chirinos, E. de Marchena, T. Salerno, and A. Ferreira
Development of a Score to Predict the Need for Coronary Artery Bypass Graft Surgery in Patients With Non-ST Segment Elevation Acute Coronary Syndromes
Ann. Thorac. Surg.,
December 1, 2004;
78(6):
2022 - 2026.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. W. Boonstra and W. van Oeveren
Clopidogrel and Postoperative Bleeding
Ann. Thorac. Surg.,
November 1, 2004;
78(5):
1522 - 1522.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. W.A. Chu, S. R. Wilson, R. J. Novick, L. W. Stitt, and M. A. Quantz
Does Clopidogrel Increase Blood Loss Following Coronary Artery Bypass Surgery?
Ann. Thorac. Surg.,
November 1, 2004;
78(5):
1536 - 1541.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Arsan, K. AK, and S. C. Isbir
Clopidogrel in coronary artery surgery
Eur. J. Cardiothorac. Surg.,
October 1, 2004;
26(4):
869 - 869.
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. K. H. Wiegand, D. LeJeune, F. Boguschewski, H. Bonnemeier, F. Eberhardt, H. Schunkert, and F. Bode
Pocket Hematoma After Pacemaker or Implantable Cardioverter Defibrillator Surgery: Influence of Patient Morbidity, Operation Strategy, and Perioperative Antiplatelet/Anticoagulation Therapy
Chest,
October 1, 2004;
126(4):
1177 - 1186.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A.A. Fox, S. R. Mehta, R. Peters, F. Zhao, N. Lakkis, B. J. Gersh, and S. Yusuf
Benefits and Risks of the Combination of Clopidogrel and Aspirin in Patients Undergoing Surgical Revascularization for Non-ST-Elevation Acute Coronary Syndrome: The Clopidogrel in Unstable angina to prevent Recurrent ischemic Events (CURE) Trial
Circulation,
September 7, 2004;
110(10):
1202 - 1208.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Chen, A. W. Bracey, R. Radovancevic, J. R. Cooper Jr, C. D. Collard, W. K. Vaughn, and N. A. Nussmeier
Clopidogrel and bleeding in patients undergoing elective coronary artery bypass grafting
J. Thorac. Cardiovasc. Surg.,
September 1, 2004;
128(3):
425 - 431.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Shore-Lesserson, K. A. Tanaka, J. H. Levy, S. Pothula, V. T. Sanchala, B. Nagappala, and M. A. Inchiosa Jr.
Antiplatelet Agents and Bleeding After Cardiac Surgery * Response
Anesth. Analg.,
September 1, 2004;
99(3):
947 - 948.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Sadanandan, C. P. Cannon, C. M. Gibson, S. A. Murphy, P. M. DiBattiste, E. Braunwald, and the TIMI Study Group
A risk score to estimate the likelihood of coronary artery bypass surgery during the index hospitalization among patients with unstable angina and non-ST-segment elevation myocardial infarction
J. Am. Coll. Cardiol.,
August 18, 2004;
44(4):
799 - 803.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. L. Stadius
Diminishing returns ...and too many choices ...the saga of pharmacologic therapy to reduce the complications of percutaneous coronary intervention
J. Am. Coll. Cardiol.,
July 7, 2004;
44(1):
25 - 27.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Englberger, B. Faeh, P. A. Berdat, F. Eberli, B. Meier, and T. Carrel
Impact of clopidogrel in coronary artery bypass grafting
Eur. J. Cardiothorac. Surg.,
July 1, 2004;
26(1):
96 - 101.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. G. Raja
Clopidogrel before coronary artery surgery: bleeding or no bleeding?
Eur. J. Cardiothorac. Surg.,
July 1, 2004;
26(1):
231 - 231.
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Myhre, R. Stenseth, A. Karevold, L. Bjella, P. S. Lingaas, P. O. Olsen, R. Haaverstad, I. Kirkeby-Garstad, and O. Walle Levang
Bleeding Following Coronary Surgery After Preoperative Low-Molecular-Weight Heparin
Asian Cardiovasc Thorac Ann,
March 1, 2004;
12(1):
3 - 6.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Sanisoglu, M. Guden, Z. Bayramoglu, E. Sagbas, C. Dibekoglu, S. Y. Sanisoglu, and B. Akpinar
Does off-pump CABG reduce gastrointestinal complications?
Ann. Thorac. Surg.,
February 1, 2004;
77(2):
619 - 625.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. D. Smout, D. P. Mikhailidis, B. K. Shenton, and G. Stansby
Combination Antiplatelet Therapy in Patients with Peripheral Vascular Bypass Grafts
Clinical and Applied Thrombosis/Hemostasis,
January 1, 2004;
10(1):
9 - 18.
[Abstract]
[PDF]
|
|
|
|
|
|
|
U. Klima, V. Falk, M. Maringka, S. Bargenda, S. Badack, A. Moritz, F. Mohr, A. Haverich, and G. Wimmer-Greinecker
Magnetic vascular coupling for distal anastomosis in coronary artery bypass grafting: A multicenter trial
J. Thorac. Cardiovasc. Surg.,
November 1, 2003;
126(5):
1568 - 1574.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. J. Kereiakes
Adjunctive Pharmacotherapy before Percutaneous Coronary Intervention in Non-ST-Elevation Acute Coronary Syndromes: The Role of Modulating Inflammation
Circulation,
October 21, 2003;
108(90161):
III-22 - 27.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Braunwald
Application of Current Guidelines to the Management of Unstable Angina and Non-ST-Elevation Myocardial Infarction
Circulation,
October 21, 2003;
108(90161):
III-28 - 37.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E. Tcheng and M. E. Campbell
Platelet inhibition strategies in percutaneous coronary intervention: Competition or coopetition?
J. Am. Coll. Cardiol.,
October 1, 2003;
42(7):
1196 - 1198.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Mehran, E. D. Aymong, D. T. Ashby, T. Fischell, H. Whitworth Jr, R. Siegel, W. Thomas, S. C. Wong, R. Narasimaiah, A. J. Lansky, et al.
Safety of an Aspirin-Alone Regimen After Intracoronary Stenting With a Heparin-Coated Stent: Final Results of the HOPE (HEPACOAT and an Antithrombotic Regimen of Aspirin Alone) Study
Circulation,
September 2, 2003;
108(9):
1078 - 1083.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. B. Ross and G. S. Dhillon
Ventriculostomy-related Cerebral Hemorrhages after Endovascular Aneurysm Treatment
AJNR Am. J. Neuroradiol.,
September 1, 2003;
24(8):
1528 - 1531.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Prasad, V. Mathew, D. R Holmes Jr., and B. J Gersh
Current management of non-ST-segment-elevation acute coronary syndrome: reconciling the results of randomized controlled trials
Eur. Heart J.,
September 1, 2003;
24(17):
1544 - 1553.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. M. Dorhout Mees, G. J.E. Rinkel, J. W. Hop, A. Algra, and J. van Gijn
Antiplatelet Therapy in Aneurysmal Subarachnoid Hemorrhage: A Systematic Review
Stroke,
September 1, 2003;
34(9):
2285 - 2289.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. N. Levine, M. J. Kern, P. B. Berger, D. L. Brown, L. W. Klein, D. J. Kereiakes, T. A. Sanborn, A. K. Jacobs, and for the American Heart Association Diagnostic and
Management of Patients Undergoing Percutaneous Coronary Revascularization
Ann Intern Med,
July 15, 2003;
139(2):
123 - 136.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. H. Kincaid, M. L. Monroe, D. L. Saliba, N. D. Kon, W. G. Byerly, and M. G. Reichert
Effects of preoperative enoxaparin versus unfractionated heparin on bleeding indices in patients undergoing coronary artery bypass grafting
Ann. Thorac. Surg.,
July 1, 2003;
76(1):
124 - 128.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Akowuah, V. Shrivastava, and G. Cooper
Coronary artery bypass graft surgery in patients with recent exposure to clopidogrel and aspirin therapy
J. Am. Coll. Cardiol.,
April 16, 2003;
41(8):
1425 - 1426.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. R. Yee, R. H. Hongo, and J. Ley
Reply
J. Am. Coll. Cardiol.,
April 16, 2003;
41(8):
1427 - 1428.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. P. Choudhury
Clopidogrel and Percutaneous Coronary Interventions
JAMA,
April 16, 2003;
289(15):
1925 - 1925.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. E. Charlson and O. W. Isom
Care after Coronary-Artery Bypass Surgery
N. Engl. J. Med.,
April 10, 2003;
348(15):
1456 - 1463.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. B. Berger and S. Steinhubl
Clinical Implications of Percutaneous Coronary Intervention-Clopidogrel in Unstable angina to prevent Recurrent Events (PCI-CURE) Study: A US Perspective
Circulation,
October 22, 2002;
106(17):
2284 - 2287.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Clopidogrel Increases Postoperative Bleeding
Journal Watch Cardiology,
September 20, 2002;
2002(920):
2 - 2.
[Full Text]
|
|
|
|
