Prevention of early aortocoronary bypass occlusion by low-dose aspirin and dipyridamole. Grupo Español para el Seguimiento del Injerto Coronario (GESIC)
Ginés Sanz,A Pajarón,E Alegría,I Coello,M Cardona,J A Fournier,M Gómez-Recio,J Ruano,R Hidalgo,A Medina +9 more
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Low-dose aspirin plus dipyridamole safely improves early saphenous vein aortocoronary vein graft patency; this effect is an added benefit to a preoperative regimen of dipyrIDamole.Abstract:
To analyze the efficacy of low-dose aspirin in preventing early aortocoronary vein graft occlusion, 1,112 consecutive patients were enrolled in a multicenter, randomized, double-blind, placebo-controlled trial comparing 50 mg t.i.d. aspirin, 50 mg aspirin plus 75 mg t.i.d. dipyridamole, and placebo. All patients received 100 mg q.i.d. dipyridamole for 48 hours before surgery, and assigned treatment was started 7 hours after surgery. Vein graft angiography was performed in 927 patients (83%) within 28 days of surgery (mean, 10 days). Aspirin plus dipyridamole significantly (p = 0.017) reduced the occlusion rate of distal anastomoses from 18% (placebo) to 12.9%. Occlusion rate in the aspirin group was 14%, which approached statistical significance (p = 0.058). Furthermore, only aspirin plus dipyridamole reduced (p = 0.01) the number of patients with occluded grafts (placebo, 33%; aspirin, 27.1%; aspirin plus dipyridamole, 24.3%). Mediastinal drainage was slightly higher (p = 0.04) in the aspirin plus dipyridamole group (713 +/- 456 ml) than in the other two groups (placebo, 670 +/- 437 ml; aspirin, 629 +/- 337 ml), but hospital mortality (average, 4.6%) and early reoperation (average, 3.9%) rates were similar among the three groups. Thus, low-dose aspirin plus dipyridamole safely improves early saphenous vein aortocoronary graft patency; this effect is an added benefit to a preoperative regimen of dipyridamole.read more
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Collaborative overview of randomized trials of antiplatelet therapy .1. prevention of death, myocardial-infarction, and stroke by prolonged antiplatelet therapy in various categories of patients
R Altman,L Carreras,R Diaz,E Figueroa,E Paolasso,J C Parodi,J F Cade,G Donnan,M J Eadie,T P Gavaghan,E F Osullivan,D Parkin,Renny Jtg.,C Silagy,H Vinazzer,F Zekert,H Adriaensen,J M Bertrandhardy,M Bran,J L David,J Dricot,E Lavennepardonge,R Limet,A Lowenthal,M Moriau,S Schapira,P Smets,J Symoens,R Verhaeghe,Marc Verstraete,A Atallah,H Barnett,R Batista,J Blakely,J A Cairns,R Cote,J Crouch,G Evans,J M Findlay,M Gent,Y Langlois,J Leclerc,J Norris,G F Pineo,P J Powers,R Roberts,L Schwartz,J Sicurella,W Taylor,P Theroux,Alexander G.G. Turpie,R D Weisel,J Cui,L Liu,J Pirk,C Bay,G Boysen,J B Knudsen,P Petersen,P S Sorensen,H K Tonnesen,P T Harjola,J C Arcan,B Balkau,J Blanchard,J P Boissel,B Boneu,M G Bousser,M Brochier,M Cloarec,G Cribier,M Dechavanne,P Drouin,E Eschwege,B Guiraudchaumeil,R Hugonot,A Leizorovicz,Y Loria,L Michat,J Mirouze,E Panak,J Pasteyer,A Rascol,L Revol,Maarten Van Roy,J Selles,G Slama,C Starkman,M Teule,N Thibult,M Verry,F W Albert,K Andrassy,K Breddin,R Eckel,A Encke,J Frohlich,B Hartung,H W Heiss,H Hess,B Hofling,D Krause,G Latta,H Linke,D Loew,R Lorenz,K Middleton,G Novak,M Oldendorf,N Pfluger,D Raithel,R Reuter,G Schettler,J Schnitker,W Schoop,H Stiegler,K Uberla,G Vogel,M Weber,I Welbers,E Zeitler,G Arapakis,T Chan,C K Mok,R Szabo,N P Misra,K Reddy,G A Fitzgerald,A Apollonio,F Balsano,A Basellini,L Candelise,Mariella Catalano,N Ciavarella,G Ciuffetti,S Coccheri,M Cortellaro,G Corvi,V Coto,Giovanni Davì,R Decaterina,T Diperri,C Fieschi,R Gentile,L Gregoratti,Paolo Gresele,M Lavezzari,A Libretti,B Magnani,G.G. Nenci,G Pagano,Carlo Patrono,L Pedrini,M Pini,Paolo Prandoni,F Romeo,F Rovelli,G Rudelli,G Ruvolo,G P Signorini,G Tognoni,Francesco Violi,T Fujimori,M Kageyama,T Katsumura,S Kitamura,K Maeda,A Suzuki,H Tohgi,S Uchiyama,H Utsumi,A M Garcia,A Algra,Denottolander Gjh.,Kupper Ajf.,J Vangijn,H Hart,L J Kappelle,P J Koudstaal,T Lemmens,J Lodder,M Pannebakker,P W Serruys,A Vandenbelt,J Vandermeer,A B Vandervijgh,Verheugt Fwa.,G Veth,J Dale,K A Johannessen,E Thaulow,P Popescu,N Tiberiu,Aznar Jrd.,E Esmatjes,P Guiteras,J Lasierra,P Lopeztrigo,A Oriol,L Pomar,E Rocha,F D Sanchez,J Sanchorieger,G Sanz,Berglund Ulf.,C Blomstrand,M Boberg,M Britton,C E Elwin,C Helmers,J Holm,L Janzon,S Juulmoller,H Mulec,J E Olsson,S Persson,G Rasmanis,A Rosen,K Samuelsson,J Soreff,N Wahlgren,L Wallentin,H R Baur,M Bokslag,A Bollinger,B Meier,M Pfisterer,C Sitthiamorn,E J Acheson,P Appleby,A W Asscher,A Aukland,Colin Baigent,S Bala,A H Barnett,P Bell,S Bews,Born Gvr.,J P Branagan,N Brooks,M J Brown,N L Browse,R Capildeo,M Carmalt,A E Carter,I Chalmers,Mike Clarke,Robert Clarke,Clyne Cac.,Rory Collins,Cooke,G Coutts,D H Cove,P S Crowther,W F Cuthbertson,D Debono,C Dickerson,J P Dickinson,Richard Doll,J A Dormandy,D Dunbabin,S Ell,P Elphinstone,P Elwood,V Englishby,B Farrell,C Fiskerstrand,M Flather,T Foley,T Foulds,K M Fox,Peter Franks,H Fraser,T Gardecki,M Gawel,A E Gent,A H Gershlick,J Godwin,M Goldman,C Gray,D Gray,Richard Gray,H Handoll,G Hankey,Harrison Mjg.,N Henderson,S Heptinstall,S F Hobbiger,E W Jones,Jones Nag.,S Jost,D Julian,J Kellett,R C Kester,G Lowe,J Mackenzie,C N McCollum,G Mead,T W Meade,D Mendelow,J C Miller,G K Morris,C Nichol,M Noble,Obrien,M Ogier,Sarah Parish,M J Parry,Richard Peto,Janet T. Powell,P Pozzilli,N Qizilbash,A Rahman,S M Rajah,D H Richards,S Richards,Ruth M. Ripley,V C Roberts,F C Rose,Russell Rwr.,P C Rubin,C V Ruckley,Peter Sandercock,Shaw Mdm.,K M Shaw,J H Shelley,J Slattery,Peter Sleight,S J Smith,P Stewartlong,P M Sweetnam,Tansey Mjb.,H Tindall,J Turney,H M Tyler,N C Varey,M P Vessey,M G Walker,M A Walker,C P Warlow,R G Wilcox,H Willems,E H Wood,E Wynjones,H P Adams,B Barton,R F Bedford,B L Bick,S Bingham,B G Brown,T Bryant,J Buring,C F Cabot,P Canner,J Chesebro,O D Chrisman,G P Clagett,J A Colwell,M Dyken,D Ellis,W S Fields,C Furberg,V Fuster,S Goldman,J Granett,R M Green,D Green,R Hardy,L A Harker,W H Harris,R G Hart,W K Hass,Charles H. Hennekens,D Hill,M Hume,M C Igloe,G Johnson,S Jonas,G Knatterud,T R Kohler,N J Lembo,D Lewis,E Lockhart,P Majerus,Mcenany,R Mckenna,J L Mehta,J S Meyer,B Molony,T Moritz,D M Nicoloff,G Nycz,H Ono,G A Pantely,S J Phillips,Paul M. Ridker,J T Robertson,R Rothbart,E W Salzman,R D Sautter,R C Schlant,J A Schoenberger,M V Sengekontacket,G Sharma,P Steele,K P Steinnagel,J Stratton,J M Sullivan,G Timmis,J F Toole,Walker,S Weisman,C W White,M Wirecki,D Wombolt,R Wong,Salim Yusuf,K Zadina,D Zucker +418 more
TL;DR: There was no appreciable evidence that either a higher aspirin dose or any other antiplatelet regimen was more effective than medium dose aspirin in preventing vascular events, so in each of the four main high risk categories overall mortality was significantly reduced.
Journal ArticleDOI
ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction
Elliott M. Antman,Daniel T. Anbe,Paul W. Armstrong,Eric R. Bates,Lee A. Green,Mary M. Hand,Judith S. Hochman,Harlan M. Krumholz,Frederick G. Kushner,Gervasio A. Lamas,Charles J. Mullany,Joseph P. Ornato,David L. Pearle,Michael A. Sloan,Sidney C. Smith,Joseph S. Alpert,Jeffrey L. Anderson,David P. Faxon,Valentin Fuster,Raymond J. Gibbons,Gabriel Gregoratos,Jonathan L. Halperin,Loren F. Hiratzka,Sharon A. Hunt,Alice K. Jacobs +24 more
TL;DR: This document was approved by the American College of Cardiology Foundation Board of Trustees on May 7, 2004 and by theAmerican Heart Association Science Advisory and Coordinating Committee on May 5, 2004.
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1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction)
Thomas J. Ryan,Elliott M. Antman,Neil H. Brooks,Robert M. Califf,L. David Hillis,Loren F. Hiratzka,Elliot Rapaport,Barbara Riegel,R. O. Russell,Earl E. Smith,W. Douglas Weaver,Raymond J. Gibbons,Joseph S. Alpert,Kim A. Eagle,Timothy J. Gardner,Arthur Garson,Gabriel Gregoratos,Sidney C. Smith +17 more
TL;DR: These guidelines are intended for physicians, nurses, and allied healthcare personnel who care for patients with suspected or established acute myocardial infarction and promote rapid identification and treatment of patients with acute MI.
Journal ArticleDOI
ACC/AHA Guidelines for the Management of Patients With Acute Myocardial Infarction
Thomas J. Ryan,Jeffrey L. Anderson,Elliott M. Antman,Blaine A. Braniff,Neil H. Brooks,Robert M. Califf,L. David Hillis,Loren F. Hiratzka,Elliott Rapaport,Barbara Riegel,R. O. Russell,Earl E. Smith,W. Douglas Weaver,James L. Ritchie,Melvin D. Cheitlin,Kim A. Eagle,Timothy J. Gardner,Arthur Garson,Raymond J. Gibbons,Richard P. Lewis,Robert A. O'Rourke +20 more
TL;DR: The American College of Cardiology and the American Heart Association request that the following format be used when citing this document: Ryan TJ, Antman EM, Brooks NH, Califf RM, Hillis LD, Hiratzka LF, Rapaport E, Riegel B, Russell RO, Smith EE III, Weaver WD.
Journal ArticleDOI
Aspirin as an antiplatelet drug.
TL;DR: A rational basis for antithrombotic prophylaxis and treatment with aspirin is described and basic information on the molecular mechanism of action of aspirin in inhibiting platelet function will be integrated with the appropriate clinical pharmacologic data and the results of randomized clinical trials.
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