Antithrombotic strategies for preventing graft failure in coronary artery bypass graft.

Autor: Mauro MS; Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Via Santa Sofia, 78, Catania, Italy., Finocchiaro S; Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Via Santa Sofia, 78, Catania, Italy., Calderone D; Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Via Santa Sofia, 78, Catania, Italy., Rochira C; Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Via Santa Sofia, 78, Catania, Italy., Agnello F; Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Via Santa Sofia, 78, Catania, Italy., Scalia L; Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Via Santa Sofia, 78, Catania, Italy., Capodanno D; Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Via Santa Sofia, 78, Catania, Italy. dcapodanno@unict.it.
Jazyk: angličtina
Zdroj: Journal of thrombosis and thrombolysis [J Thromb Thrombolysis] 2024 Apr; Vol. 57 (4), pp. 547-557. Date of Electronic Publication: 2024 Mar 16.
DOI: 10.1007/s11239-023-02940-5
Abstrakt: Coronary artery bypass graft (CABG) procedures face challenges related to graft failure, driven by factors such as acute thrombosis, neointimal hyperplasia, and atherosclerotic plaque formation. Despite extensive efforts over four decades, the optimal antithrombotic strategy to prevent graft occlusion while minimizing bleeding risks remains uncertain, relying heavily on expert opinions rather than definitive guidelines. To address this uncertainty, we conducted a review of randomized clinical trials and meta-analyses of antithrombotic therapy for patients with CABG. These studies examined various antithrombotic regimens in CABG such as single antiplatelet therapy (aspirin or P2Y 12 inhibitors), dual antiplatelet therapy, and anticoagulation therapy. We evaluated outcomes including the patency of grafts, major adverse cardiovascular events, and bleeding complications and also explored future perspectives to enhance long-term outcomes for CABG patients. Early studies established aspirin as a key component of antithrombotic pharmacotherapy after CABG. Subsequent randomized controlled trials focused on adding a P2Y 12 inhibitor (such as clopidogrel, ticagrelor, or prasugrel) to aspirin, yielding mixed results. This article aims to inform clinical decision-making and guide the selection of antithrombotic strategies after CABG.
(© 2024. The Author(s).)
Databáze: MEDLINE
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