Friday November 20, 2009
CASCADE: Aspirin alone as effective as aspirin plus clopidogrel in preventing vein graft disease post-CABG


Aspirin alone is as effective as aspirin and clopidogrel in preventing vein graft disease after CABG, results of the CASCADE trial demonstrated, suggesting that the use of dual antiplatelet therapy is not supported in this population.

CASCADE researchers randomly assigned 113 patients undergoing primary multivessel CABG with at least two saphenous vein grafts to either 162 mg aspirin daily and 75 mg clopidogrel daily (n=56) or 162 mg aspirin daily and placebo (n=57). Primary outcome was vein graft intimal hyperplasia, with intimal area measured by IVUS. The study was powered for 20% clinically-relevant reduction with clopidogrel.

At one year, patency did not differ between the groups; overall patency was 95.2% in the treatment group and 95.5% in the placebo group (P=1.00).

Freedom from individual major adverse cardiac events – stroke, death and MI – and a composite of all three was similar in both groups (P=.76), as was major and minor bleeding (P=.02).


Source:

Kulik A. Presented at: American Heart Association Scientific Sessions 2009; Nov. 14-18, 2009; Orlando, Fla - http://www.theheart.org/article/1024575.do