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Antiplatelet therapy before saphenous vein graft intervention decreased adverse events
Prehospital use of antiplatelet therapy was associated with a lower occurrence of major adverse cardiac events after saphenous vein graft intervention, according to study results.
To examine the association between antiplatelet regimens before hospitalization and outcomes after saphenous vein graft (SVG) procedures, researchers looked at 225 consecutive patients who presented with stable angina or ACS and underwent PCI from 2003 to 2008. Patients were divided by their antiplatelet regimen: 21 (9.4%) receiving no antiplatelet therapy, 102 (45.3%) receiving aspirin or clopidogrel, and 102 (45.3%) receiving dual antiplatelet therapy.
The rate of the composite outcome of all-cause mortality, MI, stroke and the need for additional revascularization at 30 days was 38.1% in patients without antiplatelet therapy before hospitalization, 14.9% in patients taking aspirin or clopidogrel at admission, and 13.9% in patients receiving DAPT at admission (overall P=.01).
Ralf E. Harskamp
At 1 year, the composite outcome was 52.4% in patients without antiplatelet therapy, 29.5% in patients taking aspirin or clopidogrel, and 28.3% in patients taking DAPT before hospital admission (overall P=.03). According to Ralf E. Harskamp, MD, one of the study’s investigators with the University of Amsterdam, the Netherlands and Duke Clinical Research Institute, Durham, N.C., antiplatelet use remained associated with the primary outcome after adjustment.
Most major cardiac events occurred during the procedure or less than 30 days afterward, the researchers wrote, suggesting that preadmission use of antiplatelet therapy could have protective properties during SVG intervention, regardless of the administration of a loading dose of aspirin and clopidogrel at the start of the PCI procedure.
However, the study was a retrospective single-center experience in which DAPT was measured at one time point only, involving a limited number of patients, Harskamp told Cardiology Today’s Intervention.
“Therefore many caveats exist concerning application of our findings in clinical practice at this time. As such, our results should be seen as hypothesis-generating, for which further study is warranted,” he said.
Disclosure: Harskamp reports no relevant financial disclosures.