ウネ　ダイ   Dai Une   畝　大    所属   川崎医科大学  医学部 臨床医学　心臓血管外科学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Eight-year follow-up of the Clopidogrel After Surgery for Coronary Artery Disease (CASCADE) trial.
掲載誌名	正式名：The Journal of thoracic and cardiovascular surgery 略　 称：J Thorac Cardiovasc Surg ISSNコード：1097685X/00225223
掲載区分	国外
巻・号・頁	155(1),pp.212-222.e2
著者・共著者	Ali Hage, Pierre Voisine, Fernanda Erthal, Éric Larose, David Glineur, Benjamin Chow, Hugo Tremblay, Jacqueline Fortier, Gifferd Ko, Dai Une, Michael Farkouh, Thierry G Mesana, Michel LeMay, Alexander Kulik, Marc Ruel
発行年月	2018/01
概要	OBJECTIVE:In this 8 years' follow-up study, we evaluated the long-term outcomes of the addition of clopidogrel to aspirin during the first year after coronary artery bypass grafting, versus aspirin plus placebo, with respect to survival, major adverse cardiac, or major cerebrovascular events, including revascularization, functional status, graft patency, and native coronary artery disease progression.METHODS:In the initial Clopidogrel After Surgery for Coronary Artery Disease trial, 113 patients were randomized to receive either daily clopidogrel (n = 56) or placebo (n = 57), in addition to aspirin, in a double-blind fashion for 1 year after coronary artery bypass grafting. All patients were re-evaluated to collect long-term clinical data. Surviving patients with a glomerular filtration rate > 30 mL/min were asked to undergo a coronary computed tomography angiogram to evaluate the late saphenous vein graft patency and native coronary artery disease progression.RESULTS:At a median follow-up of 7.6 years, survival rate was 85.5% ± 3.8% (P = .23 between the 2 groups). A trend toward enhanced freedom from all-cause death or major adverse cardiac or cerebrovascular events, including revascularization, was observed in the aspirin-clopidogrel group (P = .11). No difference in functional status or freedom from angina was observed between the 2 groups (P > .57). The long-term patency of saphenous vein graft was 89.11% in the aspirin-clopidogrel group versus 91.23% in the aspirin-placebo group (P = .79). A lower incidence of moderate to severe native disease progression was observed in the aspirin-clopidogrel group versus the aspirin-placebo group (7 out of 122 vs 13 out of 78 coronary segments that showed progression, respectively [odds ratio, 0.3 ± 0.2; 95% confidence interval, 0.1-0.8; P = .02]).CONCLUSIONS:At 8 years' follow-up, the addition of clopidogrel to aspirin during the first year after coronary artery bypass grafting exhibited a lower incidence of moderate to sev
DOI	10.1016/j.jtcvs.2017.06.039
PMID	28734623