Copyright © 1989 by the European Society of Cardiology.
© 1989 The European Society of Cardiology
Prevention of aortocoronary vein-graft attrition with low-dose aspirin and triflusal, both associated with dipyridamole: a randomized, double-blind, placebo-controlled trial
*Cardiac Catheterization and Invasive Cardiology Unit Barcelona Spain
Clinical Pharmacy Unit Barcelona Spain
Cardiac Surgery Unit Barcelona Spain
||Haematology Service of the Hospital de la Santa Creu i Sant Pau Barcelona Spain
Received 18 April 1988; revised 19 July 1988; .
Address for reprints: A. Oriol MD. Hemodinamica, Hospital de la Santa Creu i Sant Pau, Av. Pare Claret 167, Barcelona 08025, Spain.
Abstract
A randomized, double-blind, placebo-controlled trial was performed in 209 patients to evaluate the efficacy of a low dose of aspirin plus dipyridamole or that of a new antiplatelet agent (triflusal) plus dipyridamole in the prevention of aortocoronary vein-graft occlusion. An angiographic control performed in 161 patients 9 days after surgery showed no significant differences between groups, but a new control on 138 of those patients 6 months later did show significant linear trends towards fewer distal anastomosis occlusions (P = 0.027) from theplacebo (24%,22/91) totheaspirin (16%, 17/106) andto the trifusal groups (12%, 10/86), and towards fewer new occlusions (P = 0.056) from 12% (9/78) to 10% (10/99) and to 2.6% (2/78) .respectively, in the same groups. A multivariate logistic regression model, used to determine the effect of 33 variables on distal anastomosis occlusion at 6 months control, demonstrated that diameter of distal bed (P = 0.006), moderately to severely atherosclerotic distal bed (P = 0.003) and the interactions between poor distal bed and triflusal (P = 0.005) were independent predictors of occlusion. Thus, triflusal plus dipyridamole appeared superior to low-dose aspirin plus dipyridamole in the prevention of vein-graft occlusion, independently of coronary and vein-graft determinants of occlusion.
Key Words: Coronary artery grafting • saphenous vein graft • triflusal • aspirin • dipyridamole • antiplatelet agents
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