Author + information
- Alice Wang,
- Angie Wu,
- Daniel Wojdyla,
- Renato Lopes,
- L. Kristin Newby,
- Mark Newman,
- Peter K. Smith and
- John Alexander
Background: Perioperative myocardial infarction (periop MI) after CABG has been associated with worse outcome. We assessed the association between clopidogrel use and short-term outcomes in patients with periop MI following CABG surgery.
Methods: We used data from 3 clinical trials: RED-CABG, MEND-CABG II and PREVENT IV (n=9117). A periop MI was defined as having a CK-MB value >5 times the upper limit of normal within 24 hours of surgery (n=2052). Clopidogrel use was identified if a patient was given clopidogrel after surgery and pre-discharge. A Cox regression model estimated the hazard ratio comparing clopidogrel vs. no clopidogrel for the composite endpoint of all-cause mortality, MI or stroke and for rehospitalization.
Results: Clopidogrel use (n=527) and no clopidogrel use (n=1525) were similar in comorbidities. Median age was 66 (58-72.3), 42% had diabetes, 12% had prior stroke, 17.6% had heart failure, and 13.8% had peripheral vascular disease. There was no difference in MI, stroke, all-cause mortality or composite endpoint at 30 days between treatment groups (Figure) but there were significantly fewer re-hospitalizations at 30 days in the clopidogrel group (adjusted HR 0.71, CI 0.52-0.97, p=0.033).
Conclusions: Only one quarter of patients were treated for periop MI. Clopidogrel use did not result in a difference in MI, stroke, or mortality but resulted in fewer re-hospitalizations at 30 days.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Antithrombotic Therapy in Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1252-313
- 2017 American College of Cardiology Foundation