Agnew T M, French J K, Neutze J M, Whitlock R M, Brandt P W, Kerr A R, Webber B J, Rutherford J D
Cardiology Department, Green Lane Hospital, Auckland, New Zealand.
Aust N Z J Med. 1992 Dec;22(6):665-70. doi: 10.1111/j.1445-5994.1992.tb04868.x.
One hundred and one subjects were randomised to receive either aspirin 100 mg or aspirin 100 mg + dipyridamole 300 mg daily before undergoing coronary bypass surgery. The drugs were commenced at least 36 hours before operation and patients were followed for one year. There were three perioperative deaths and 37 withdrawals, of which 14 were drug related (aspirin four, aspirin + dipyridamole ten). Cineangiocardiograms at nine weeks and one year showed vein graft patency rates of 93% and 87% for subjects treated with aspirin alone; and 90% and 89% in those who received aspirin+dipyridamole. During the follow-up period 14% of 232 coronary lesions in the aspirin treated group advanced by more than two grades compared with 15% of 315 lesions in the aspirin+dipyridamole group. The study did not establish superiority of one regimen over another in terms of graft patency or progress of lesions in native vessels. However, low dose aspirin was better tolerated than combination therapy.
101名受试者在接受冠状动脉搭桥手术前被随机分组，分别每日服用100毫克阿司匹林或100毫克阿司匹林加300毫克双嘧达莫。这些药物在手术前至少36小时开始服用，患者被随访一年。围手术期有3例死亡，37例退出研究，其中14例与药物有关（阿司匹林组4例，阿司匹林加双嘧达莫组10例）。9周和1年时的心血管造影显示，单独使用阿司匹林治疗的受试者静脉移植物通畅率分别为93%和87%；接受阿司匹林加双嘧达莫治疗的受试者通畅率分别为90%和89%。在随访期间，阿司匹林治疗组232处冠状动脉病变中有14%进展超过两级，而阿司匹林加双嘧达莫组315处病变中有15%进展超过两级。该研究未证实一种治疗方案在移植物通畅率或自身血管病变进展方面优于另一种方案。然而，低剂量阿司匹林的耐受性优于联合治疗。
