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Bypass grafting: outcomes and efficiency of antiplatelet treatment

Authors: Yu.I. Grinshteyn1, A.A. Kosinova1, T.S. Mongush1 2, M.D. Goncharov1 2

Company: 1 Prof. V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Krasnoyarsk, 660022, Russian Federation
2 Federal Center for Cardiovascular Surgery, Krasnoyarsk, 660020, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2020-14-2-138-149

For citation: Grinshteyn Yu.I., Kosinova A.A., Mongush T.S., Goncharov M.D. Bypass grafting: outcomes and effi- ciency of antiplatelet treatment. Creative Cardiology. 2020; 14 (2): 138–49 (in Russ.). DOI: 10.24022/1997-3187- 2020-14-2-138-149

Received / Accepted:  22.05.2020 / 29.05.2020

Keywords: bypass grafting outcomes genetic polymorphisms resistance acetylsalicylic acid clopidogrel

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Abstract

The risk of developing adverse events after coronary artery bypass grafting, graft failure remains during secondary prevention with antiplatelet drugs despite successes in the development of myocardial revascularization. The caus- es of vascular events after coronary bypass surgery are multifactorial. In the pathogenesis of graft failure there are such reasons as thrombosis, conduit injury, intimal tear, reactive inflammation associated with the effect of blood pressure on the wall of the venous graft, spasm and hyperplasia. The review provides information on the outcomes of coronary bypass surgery, the reasons of graft failure by literature data. Much attention is paid to antiplatelet therapy as a secondary prevention after coronary artery bypass grafting in the light of up to date guidelines (American Thoracic Society and European Society of Cardiology), to the place of double antiplatelet therapy after intervention and its effect on outcomes. One of the important causes of graft thrombosis is primary resistance to antiplatelet drugs, due to genetic polymorphisms, therefore, one of the sections of the review is devoted to the issue of primary genetically mediated resistance to antiplatelet drugs (Acetylsalicylic acid and Clopidogrel) as a high risk factor for graft failure.

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About Authors

Yuriy I. Grinshteyn, Dr. Med. Sc., Professor, Chief of Chair, orcid.org/0000-0002-4621-1618
Aleksandra A. Kosinova, Cand. Med. Sc., Assistant Professor, orcid.org/0000-0002-7412-2516
Taira S. Mongush, Applicant, Cardiologist
Maksim D. Goncharov, Applicant, Laboratory Diagnostics Physician

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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