Influence of aspirin and dipyridamole on patency of coronary artery bypass grafts.

A prospective randomized trial was performed to determine if the administration of inhibitors of platelet function would improve the patency of coronary artery bypass grafts. Patients were operated on for intractable angina with angiographically demonstrable lesions. The left internal mammary artery (IMA) was used for bypass of lesions of the left anterior descending coronary artery (LAD). Saphenous vein grafts were used for the LAD if the IMA was inadequate and for all other vessels. Treated patients received 1,300 mg of aspirin and 100 mg of dipyridamole (Persantine) orally each day. Control patients received neither drug. Patients returned 3 to 6 months after operation for repeat angiography. Results were analyzed by chi-square. One hundred seventy-four patients entered the study from June, 1973, through December, 1975, and 113 were analyzed. In the control group, 66 patients had 27 IMA-LAD grafts and 93 saphenous vein grafts. In the treatment group, 47 patients underwent 18 IMA-LAD grafts and 75 saphenous vein grafts. Ninety-eight of the 120 grafts (82%) were patent in the control group, and 87 of 93 grafts (94%) were patent in the treatment group (x2 = 6.34, p less than 0.02). Of the 45 IMA-LAD grafts in both groups, only 1 was occluded, a patency of 98%. In the control group, 72 of 93 saphenous vein grafts (77%) were patent. In the treatment group, 69 of 75 (92%) were patent (x2 = 6.54, p less than 0.02). The results of the study show a 15% difference between the two groups in the early patency of saphenous vein grafts. We continue to use aspirin and dipyridamole to improve the patency of saphenous vein bypass grafts.

RCT Entities:   Population Interventions Outcomes