EFFECT OF DIPYRIDAMOLE AND ASPIRIN ON LATE VEIN-GRAFT PATENCY AFTER CORONARY-BYPASS OPERATIONS
EFFECT OF DIPYRIDAMOLE AND ASPIRIN ON LATE VEIN-GRAFT PATENCY AFTER CORONARY-BYPASS OPERATIONS
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DOI：
10.1056/nejm198401263100401
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发表时间：
1984-01-01
影响因子：
158.5
通讯作者：
FRYE, RL
中科院分区：
文献类型：
--
作者：
CHESEBRO, JH;FUSTER, V;FRYE, RL
为了研究预防主动脉冠状动脉搭桥术闭塞，我们进行了一项前瞻性、随机、双盲试验，对 407 名患者长期服用双嘧达莫（手术前 2 天开始）加阿司匹林（手术后 7 小时开始）与安慰剂进行比较。 1 个月时的结果。研究表明，接受双嘧达莫和阿司匹林治疗的患者的移植物闭塞率有所降低。 343 名患者 (84%) 在 11-18 个月内进行了静脉移植血管造影。术后（中位时间为 12 个月），治疗组 478 例静脉移植物远端吻合中有 11% 闭塞，安慰剂组 486 例中有 25% 闭塞。治疗组 171 名患者中，一处或多处远端吻合口闭塞的患者比例为 22%，安慰剂组 172 名患者中，这一比例为 47%。所有移植物均在一个月内获得专利。安慰剂组 94 名患者和治疗组 116 名患者的手术情况；晚期闭塞发生率从安慰剂组的 27% 降至治疗组的 16%。双嘧达莫和阿司匹林对于预防术后晚期静脉移植物闭塞明显有效，并且这种治疗显然应持续至少1年。
To study the prevention of occlusion of aorto-coronary-artery bypass grafts, a prospective, randomized, double-blind trial was conducted comparing long-term administration of dipyridamole (begun 2 days before operation) plus aspirin (begun 7 h after operation) with placebo in 407 patients. Results at 1 mo. showed a reduction in the rate of graft occlusion in patients receiving dipyridamole and aspirin. At vein-graft angiography performed in 343 patients (84%) 11-18 mo. (median, 12 mo.) after operation, 11% of 478 vein-graft distal anastomoses were occluded in the treated group, and 25% of 486 were occluded in the placebo group. The proportion of patients with one or more distal anastomoses occluded was 22% of 171 patients in the treated group and 47% of 172 in the placebo group. All grafts were patent within a mo. of operation in 94 patients in the placebo group and 116 patients in the treated group; late development of occlusions was reduced from 27% in the placebo group to 16% in the treated group. Dipyridamole and aspirin are evidently effective in preventing vein-graft occlusion late after operation, and such treatment should apparently be continued for at least 1 yr.