Antiplatelet therapy after coronary artery bypass grafting (based on the results of a meta-analysis of clinical studies)

Authors: Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

Type:  Editorial article


DOI: https://doi.org/10.24022/1997-3187-2023-17-4-449-452

For citation: Golukhova E.Z. Antiplatelet therapy after coronary artery bypass grafting (based on the results of a meta-analysis of clinical studies). Creative Cardiology. 2023; 17 (4): 449–52 (in Russ.). DOI: 10.24022/1997-3187-2023-17-4-449-452

Received / Accepted:  25.09.2023 / 27.09.2023

Keywords: antiplatelet therapy coronary artery bypass grafting dual antiplatelet therapy



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Abstract

The author analyzes the results of meta-analysis of modern research of antiplatelet therapy (ATT) in patients with coronary artery disease after coronary artery bypass grafting (CABG). Variants of ATT after CABG include the use of aspirin or dual ATT, including a combination of aspirin with P2Y12 receptor blockers (clopidogrel, ticagrelor, prasugrel) for the prevention of thrombotic events. According to the latest meta-analysis, the frequency of resistance to ATT after CABG surgery is 39%. The results of the analysis indicate a negative prognostic effect of antiplatelet resistance, which is an increase in the risk of major cardiovascular complications, including death and myocardial infarction. The results indicate insufficient effectiveness of ATT in a number of patients after CABG. As a solution to the problem, a personalized approach is proposed, taking into account concomitant diseases (diabetes mellitus, obesity, hyperlipidemia, etc.), the results of evaluation of platelet function, as well as individual protocols for the use of ATT in patients after CABG. These protocols including the use of increased doses of antiplatelet agents, the transition to stronger antiplatelet agents, the use of dual ATT.

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About Authors

Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of RAS, Director; ORCID

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