Prevention of aorta-coronary bypass graft occlusion. Beneficial effect of XXXX on early and late patency rates of venous coronary bypass grafts: a double-blind study.

@entity1 @entity254 @entity1396 @entity1423
The efficacy of coronary bypass grafting obviously being linked to graft patency, it is compulsory to look for any innovation that could improve the patency rate. @entity1396 , an antiplatelet drug, was tested against placebo in a double-blind trial: 173 @entity1 (475 grafts) subjected to venous coronary artery bypass grafting were randomly treated with @entity1396 (250 mg twice daily) or placebo from the second postoperative day for 12 months. Graft patency was assessed by digital angiography on days 10 (99.4% of the @entity1 ), 180 (98.2%), and 360 (91.7%). The effect of treatment on @entity1423 and bleeding time were measured concomitantly; a clear-cut effect was demonstrated at each interval. Intention-to-treat graft-by-graft analysis shows that @entity1396 significantly reduced the graft occlusion rate on day 10 (7.1% versus 13.4%, p less than 0.05), day 180 (15.0% versus 24.0%, p less than 0.02), and day 360 (15.9% versus 26.1%, p less than 0.01). Sequential grafts to the left anterior descending coronary artery, with side-to-side @entity254 to diagonal branch(es), are less frequently occluded than individual grafts. On the contrary, grafts to endarterectomized vessels occlude more frequently. Individual @entity1 -by- @entity1 analysis shows that patency of all grafts at each study time, is more frequent in the @entity1396 group. The difference is significant when one considers @entity1 without sequential or endarterectomized grafts. The difference is also present at each study time: day 10 (84.4% versus 66.7%, p less than 0.05), day 180 (74.4% versus 52.3%, p less than 0.05) and day 360 (75.0% versus 52.5%, p less than 0.05). Results are even more impressive if one excludes from analysis the four @entity1 in the @entity1396 group in whom administration of the drug was delayed. This supports previous suggestions that early therapy is necessary. These results show that graft occlusion occurs mainly in the first 6 postoperative months. The incidence of occlusion is significantly reduced by @entity1396 therapy.
