Optimum Platelet Inhibition After Coronary Bypass Surgery
Summary
To investigate the effect of different dosages of aspirin on platelet aggregation and to determine the possible mechanisms of aspirin resistance, we intend to compare the effects of low, medium dose aspirin with clopidogrel (an alternative antiplatelet agent) in patients after coronary artery bypass surgery.
Timeline
- Start
- 2002-07
- Primary completion
- 2004-07
- Completion
- —
Outcome
Mixed primary results
paper Our primary outcome measure was platelet aggregation on day 5, expressed as percentage of baseline. PMID 15354104 ↗
paper The mean difference between the two arms was 42% (95% confidence interval 27%-56%) in favor of aspirin. PMID 15354104 ↗
paper Clopidogrel, unlike aspirin, did not inhibit platelet aggregation in the first 5 postoperative days PMID 15354104 ↗
paper Our primary outcome was the difference in platelet aggregation (day 5 - baseline) using 1 microg/ml of collagen. PMID 16716214 ↗
paper The baseline adjusted difference (low - medium) was 6% (95% CI -3 to 14; p = 0.19). PMID 16716214 ↗
Publications
- Results Lim E, Cornelissen J, Routledge T, Kirtland S, Charman SC, Bellm S, Munday H, Khan O, Masood I, Large S. Clopidogrel did not inhibit platelet function early after coronary bypass surgery: A prospective randomized trial. J Thorac Cardiovasc Surg. 2004 Sep;128(3):432-5. doi: 10.1016/j.jtcvs.2004.03.007.
- Results Lim E, Cornelissen J, Routledge T, Ali A, Kirtland S, Sharples L, Sheridan K, Bellm S, Munday H, Large S. Biological efficacy of low versus medium dose aspirin after coronary surgery: results from a randomized trial [NCT00262275]. BMC Med. 2006 May 22;4:12. doi: 10.1186/1741-7015-4-12.
- Lim E, Carballo S, Cornelissen J, Ali ZA, Grignani R, Bellm S, Large S. Dose-related efficacy of aspirin after coronary surgery in patients With Pl(A2) polymorphism (NCT00262275). Ann Thorac Surg. 2007 Jan;83(1):134-8. doi: 10.1016/j.athoracsur.2006.08.002.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Aspirin | Small molecule | 100 mg | — |
| Subject | Aspirin | Small molecule | 325 mg | — |
| Subject | Clopidogrel | Small molecule | 75 mg | — |