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European Heart Journal 1994 15(8):1129-1134;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Effect of various antithrombotic regimens (aspirin, aspirin plus dipyridamole, anticoagulants) on the functional status of patients and grafts one year after coronary artery bypass grafting

B. J. M. MULDER*,, R. M. VAN DER DOEF*, E. E. VAN DER WALL{dagger}, J. G. P. TIJSSEN{ddagger}, J. J. PIEK*, J. VAN DER MEER§ and A. J. DUNNING*

*Department of Cardiology, Academic Medical Centre Amsterdam The Netherlands
{dagger}Department of Cardiology, University Hospital Leiden The Netherlands
{ddagger}Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre Amsterdam The Netherlands
§Department of Cardiology, University Hospital Groningen The Netherlands

Received 4 November 1993; revised 15 February 1994; .

Correspondence: Dr Barbara J. M. Mulder, Department of Cardiology, F4, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

Abstract

From 1987 until 1991 a large prospective randomized multicentre study was performed in The Netherlands, Germany and Switzerland entitled CABADAS (Prevention of Coronary Artery Bypass graft occlusion by Aspirin, Dipyridamole, and Acenocoumaroll Phenprocoumon Study). The aim of CABADAS was to evaluate the relative efficacy of (1) aspirin, (2) aspirin plus dipyridamole, and (3) oral anticoagulants in the prevention of vein graft occlusion during the first year after aortocoronary bypass surgery. No significant difference was observed in the incidence of graft occlusion among the three treatment groups.

In a subgroup of 127 CABADAS patients, studied in the Academic Medical Centre in Amsterdam, the relationship between treatment and clinical status (i. e. symptoms of angina pectoris and exercise capacity) was assessed, and the relationship between treatment and functional status of the vein grafts was determined by means of thallium-201 exercise scintigraphy.

There were no differences in symptoms among the three treatment groups in the 127 patients studied. There were no significant differences either among the treatment groups, as regards exercise capacity and the number or intensity of perfusion defects, in the 81 patients who underwent thallium-201 exercise scintigraphy.

The three antithrombotic treatment regimens had a similar effect on the clinical status of patients and on the functional status of venous bypass grafts one year after coronary bypass surgery. This finding underscores the CABADAS results in that aspirin may be the preferred treatment option in patients following venous bypass surgery

Key Words: Anticoagulants • coronary artery bypass surgery • exercise • thalliurm-201 scintigraphy • myocardial perfusion


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