Back to Annual Meeting Posters

OBJECTIVE: Clopidogrel may be potentially beneficial after coronary surgical revascularization, especially after off-pump procedure while prothrombotic state occurs. However, there is still lack of data from prospective randomized studies comparing clopidogrel versus aspirin in head-to-head protocol.
METHODS: There were 50 elective patients who underwent off-pump coronary artery revascularization prospectively randomized to 6 month-long therapy with either aspirin (150 mg) or clopidogrel (75 mg). After 6 months all patients were turned to aspirin protocol. Preoperatively aspirin resistance was studied in all cases. Major and minor cardiovascular and cerebral events as well as safety profile data were collected 1 month, 6 and 12 months after discharge.
RESULTS: During follow-up there were 26 events recorded (including revascularization, stroke, bleeding etc.). In clopidogrel arm cumulative risk of negative event was significantly lower (14%) in comparison to aspirin group (25%, p<0,05). In aspirin resistant patients the highest cumulative event risk occurred (35%). The lowest cumulative event risk was observed in aspirin responders randomized to clopidogrel arm (2%).
CONCLUSIONS: Clopidogrel use instead of aspirin for 6 months after off-pump coronary artery revascularization is safe and related with better outcome in comparison to standard aspirin therapy. Aspirin resistance increases risk of negative events in 1 year follow-up after off-pump coronary revascularization.