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
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
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