Higher bleeding and morbidity in patients following coronary artery bypass graft surgery (CABG) is associated with preoperative clopidogrel in combination with aspirin.
Dr. Richard H. Hongo and colleagues at the Division of Cardiology, California Pacific Medical Center, San Francisco, say their findings raise worries about “the routine administration of clopidogrel before anticipated coronary stent implantation.”
They point out this combination treatment is the standard for preventing stent thrombosis prior to percutaneous coronary intervention.
Yet, they say, angiography finds surgical disease in some premedicated patients and there is concern for upcoming CABG caused by irreversible platelet inhibition.
In this evaluation of the effect of preoperative clopidogrel, 224 consecutive patients undergoing non-emergent first-time CABG were prospectively studied.
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