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抗血小板和抗凝治疗未能改善冠状动脉搭桥术后移植物通畅率:一项对照随机研究。

Failure of antiplatelet and anticoagulant therapy to improve patency of grafts after coronary-artery bypass: a controlled, randomized study.

作者信息

Pantely G A, Goodnight S H, Rahimtoola S H, Harlan B J, DeMots H, Calvin L, Rösch J

出版信息

N Engl J Med. 1979 Nov 1;301(18):962-6. doi: 10.1056/NEJM197911013011803.

Abstract

Fifty patients who underwent aortocoronary saphenous-vein bypass-graft surgery were randomly assigned to one of three groups to determine the effects of antiplatelet or anticoagulant therapy on graft patency. Twenty-four patients served as controls; 13 patients received aspirin (325 mg three times a day) and dipyridamole (75 mg three times a day); and 13 patients received closely regulated warfarin therapy. Medications were begun on the third post-operative day. Six months after surgery, all patients underwent coronary angiography to assess graft patency. There were no statistically significant differences between groups in various clinical, hemodynamic and angios, 27 of 33 grafts (82 per cent) with aspirin and dipyridamole and 29 of 37 grafts (78 per cent) with warfarin (P less than 0.5), all patients had at least one patent graft. Postoperative treatment either with aspirin and dipyridamole or with warfarin failed to improve the patency of the grafts.

摘要

五十例行主动脉冠状动脉大隐静脉旁路移植手术的患者被随机分为三组,以确定抗血小板或抗凝治疗对移植血管通畅性的影响。二十四名患者作为对照组;十三名患者接受阿司匹林(每日三次,每次325毫克)和双嘧达莫(每日三次,每次75毫克)治疗;十三名患者接受密切监测的华法林治疗。术后第三天开始用药。术后六个月,所有患者均接受冠状动脉造影以评估移植血管的通畅性。在各项临床、血流动力学和血管造影指标方面,各组之间无统计学显著差异,使用阿司匹林和双嘧达莫治疗的33条移植血管中有27条(82%)通畅,使用华法林治疗的37条移植血管中有29条(78%)通畅(P小于0.5),所有患者至少有一条移植血管通畅。术后使用阿司匹林和双嘧达莫或华法林治疗均未能提高移植血管的通畅率。

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