Clopidogrel Is Safe Early after On- and Off-pump Coronary Artery Bypass Surgery

• Published in: Journal of cardiac surgery Vol. 22; no. 6; pp. 493 - 497
• Main Authors: Chan, Vincent, Kulik, Alexander, Bourke, Michael E., Ressler, Ladislaus, Mesana, Thierry G., Ruel, Marc
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.11.2007
• Subjects: Aged; Aspirin - therapeutic use; Chest Tubes; Coronary Artery Bypass; Coronary Artery Bypass, Off-Pump; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors - adverse effects; Platelet Aggregation Inhibitors - therapeutic use; Postoperative Complications - prevention & control; Postoperative Period; Prospective Studies; Ticlopidine - adverse effects; Ticlopidine - analogs & derivatives; Ticlopidine - therapeutic use; Time Factors; Treatment Outcome
• ISSN: 0886-0440; 1540-8191
• DOI: 10.1111/j.1540-8191.2007.00475.x

Objectives: The goal of this study was to assess the safety of early postoperative clopidogrel in patients undergoing on‐pump and off‐pump coronary artery bypass graft (CABG) surgery. Methods: Observational data was collected prospectively on 117 consecutive patients who underwent primary multivessel CABG between July 2002 and June 2005. When postoperative chest tube drainage was ≤50 cc/h for 2 hours, daily clopidogrel (75 mg) and aspirin (81 mg) were initiated in 63 patients (Group CA) versus aspirin alone in 54 patients (Group A). Demographic, operative, and postoperative data were compared with linear regression and propensity‐score based techniques. Results: Total chest tube drainage and drainage after patients received antiplatelet agents were equivalent between groups. Clopidogrel administration did not increase the incidence of reexploration, transfusion, or the quantity of blood products transfused. No mortality or extrathoracic bleeding occurred in either group, and there were no differences in the incidence of adverse myocardial events or hospital length of stay. Conclusions: When given according to a predefined postoperative protocol, early postoperative clopidogrel can safely be administered in on‐pump and off‐pump CABG patients, without increasing the risk of bleeding complications. Evaluation of the benefits of clopidogrel therapy early after CABG in a randomized setting is ongoing.