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CASCADE TRIAL |
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|---|---|
| Problem | SVG patency post CABG |
| Format | Double blind RCT |
| Treatment | Aspirin +/- Clopidogrel |
| Control | Aspirin + Placebo |
| Population | 113 patients post CABG |
| Inclusion criteria | On and off pump CABG >1 SVG |
| Exclusion criteria | Excessive post op bleeding (>200ml/h/ICD) High requirement of cardiovascular support (>2 inotropes or Intra Aortic Baloon Pump) Low cardiac output syndrome (>24h requirement of inotropes) Recurrent ventricular arrhythmia Endotracheal intubation >24h Post op GI bleed Concomitant valve surgery Redo surgery Left ventricular ejection fraction <25% Renal failure Stroke Liver disease Morbid obesity |
| Follow-up | 1 year |
| Primary endpoint | Mean area of SVG intimal hyperplasia 1 year post CABG |
| Secondary endpoint(s) | Progression of diease on angiography in both native and grafted vessels MACE Blood loss via chest drain Transfusion requirement Bleeding requiring drainage or re-operation Perioperative MI GI bleeding |
| Details | - |
| Brief summary: | |
| PAPER: Aspirin plus Clopidogrel versus Aspirin along after Coronary Artery Bypass Grafting | |
|---|---|
| Date | 21 Dec 2010 |
| Journal | Circulation 2010 Dec 21;122(25):2680-7. Epub 2010 Dec 6. |
| Information | Addition of 75mg clopidogrel OD to 162mg Aspirin OD on day 1 post CABG to inhibit SVG hyperplasia ergo improving graft patency No significant difference in primary end point of mean area of SVG hyperplasia at 1y post op No significant difference on secondary angiographic end points of: All graft patency 1y post op SVG patency 1y post op IMA graft patency 1y post op Furthermore no significant difference in MACE at 1y post op No significant difference in safety end points Results remain unchanged with subgroup analysis of on pump CABG only and also with ANCOVA adjustment for significant difference in population age across treatment arms |