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      Platelet-Inhibitor Drugs before and after Coronary Artery Bypass Surgery and Coronary Angioplasty: The Basis of Their Use, Data from Animal Studies, Clinical Trial Data, and Current Recommendations

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      Cardiology

      S. Karger AG

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          Abstract

          The pathogenesis of aortocoronary vein-graft occlusion appears to be similar to the development of atherosclerosis, except that it is more accelerated, especially during the first postoperative year. Initiation of platelet-inhibitor therapy before operation is important especially in patients at high risk of bypass graft occlusion because platelet deposition starts during operation and initiates the process of occlusion. The largest and only placebo-controlled trial to start therapy before operation showed that dipyridamole (Persantine) plus aspirin markedly reduced occlusion (compared with placebo) in both high- and low-risk subgroups both early and at a median of 1 year after operation. Arterial balloon angioplasty often causes severe arterial wall injury, which is a potent stimulus for immediate platelet-thrombus deposition and is probably the main contributing factor in the process of restenosis. Animal studies suggest the potential value of antithrombotic therapy starting the day before the angioplasty procedure, but results from placebo-controlled trials in humans are needed before optimal therapy can be established.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-4402-3
          978-3-318-01827-1
          0008-6312
          1421-9751
          1986
          1986
          11 November 2008
          : 73
          : 4-5
          : 292-305
          Affiliations
          Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn., USA, and Division of Cardiology, Mount Sinai Medical Center, New York, N.Y., USA
          Article
          174022 Cardiology 1986;73:292–305
          10.1159/000174022
          2944585
          © 1986 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 14
          Categories
          Original Paper

          General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology

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