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Dai Une
Department Kawasaki Medical School Kawasaki Medical School, Department of Cardiovascular Surgery, Position Professor |
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| Article types | 原著 |
| Language | English |
| Peer review | Peer reviewed |
| Title | Eight-year follow-up of the Clopidogrel After Surgery for Coronary Artery Disease (CASCADE) trial. |
| Journal | Formal name：The Journal of thoracic and cardiovascular surgery Abbreviation：J Thorac Cardiovasc Surg ISSN code：1097685X/00225223 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | 155(1),pp.212-222.e2 |
| Author and coauthor | 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 |
| Publication date | 2018/01 |
| Summary | 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 |