Abstract | BACKGROUND: METHODS AND RESULTS: In the Clopidogrel After Surgery for Coronary Artery DiseasE (CASCADE) trial, a total of 113 patients were randomized to receive aspirin plus clopidogrel or aspirin plus placebo for 1 year after coronary artery bypass grafting. In this secondary analysis, the 92 patients who underwent preoperative and 1-year postoperative angiograms at 2 centers had each of their coronary stenoses graded serially by using 6 thresholds (grade 0 [0%-24%], grade 1 [25%-37%], grade 2 [38%-62%], grade 3 [63%-82%], grade 4 [83%-98%], and grade 5 [99%-100%]). We compared the incidence and degree of evolving coronary artery disease between the 2 treatment groups. A total of 543 preoperative stenoses and occlusions were quantified and followed. At 1-year postoperatively, there were 103 evolving (94 worsened, 9 improved) and 22 new lesions. The right coronary artery territory and sites proximal to a graft were more commonly associated with worsening coronary artery disease (P≤0.02). There were no differences in clinical events between treatment groups, and the proportion of patients with evolving or new lesions was also similar (70% versus 74%, aspirin- clopidogrel versus aspirin-placebo, respectively; P=0.8). However, in evolving or new lesions, the mean grade change (1.1±1.0 versus 1.6±1.1, respectively; P=0.01) and the proportion of new occlusions (7% versus 22%; P=0.02) were lower in the aspirin- clopidogrel group. CONCLUSIONS: CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00228423.
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Authors | Dai Une, Talal Al-Atassi, Alexander Kulik, Pierre Voisine, Michel Le May, Marc Ruel |
Journal | Circulation
(Circulation)
Vol. 130
Issue 11 Suppl 1
Pg. S12-8
(Sep 09 2014)
ISSN: 1524-4539 [Electronic] United States |
PMID | 25200049
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2014 American Heart Association, Inc. |
Chemical References |
- Platelet Aggregation Inhibitors
- Clopidogrel
- Ticlopidine
- Aspirin
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Topics |
- Aged
- Aspirin
(administration & dosage, therapeutic use)
- Clopidogrel
- Coronary Angiography
- Coronary Artery Bypass
- Coronary Artery Disease
(diagnostic imaging, drug therapy, surgery)
- Coronary Restenosis
(epidemiology, prevention & control)
- Coronary Stenosis
(drug therapy, surgery)
- Diabetes Complications
(drug therapy, surgery)
- Disease Progression
- Double-Blind Method
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Multicenter Studies as Topic
(statistics & numerical data)
- Platelet Aggregation Inhibitors
(administration & dosage, therapeutic use)
- Postoperative Complications
(epidemiology, prevention & control)
- Randomized Controlled Trials as Topic
- Risk Factors
- Ticlopidine
(administration & dosage, analogs & derivatives, therapeutic use)
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