A feasibility study of the safety and efficacy of a combined clopidogrel and aspirin regimen following off-pump coronary artery bypass grafting.
Bibliographic record
Abstract
OBJECTIVE: Effective antiplatelet therapy may decrease the risk of complications following off-pump coronary artery bypass surgery (CABG). We prospectively evaluated the safety and early efficacy of a combined regimen of clopidogrel and aspirin starting immediately after off-pump CABG. METHODS: One hundred thirty-five consecutive off-pump CABG patients received clopidogrel (75 mg/day) and aspirin (325 mg/day) orally or initially through a nasogastric tube for 3 months, commencing within 6 hours of surgery. Additionally, heparin (10,000 IU/day) was given subcutaneously during the first 4 postoperative days. Clinical events, including death, myocardial infarction (MI), reintervention, angiographically documented graft occlusion, stroke, pulmonary embolism (PE), deep vein thrombosis (DVT), and hemorrhagic events, were recorded. All patients were followed up for 3 months. RESULTS: Thirteen of 135 off-pump CABG patients had treatment discontinued before discharge because of refractory atrial fibrillation requiring warfarin sodium (Coumadin) (6 patients), gastrointestinal bleeding (1 patient), DVT (1 patient), PE (1 patient), and death (4 patients). The remaining patients were followed up for 3 months. At 1 month, the incidences of the following events were: 3.0% cerebrovascular accidents (3 strokes and 1 transient ischemic attack), 3.0% MI, 0.7% DVT, and 0.7% hemothorax. At 3 months, no additional events had occurred except for 1 patient developing DVT and 2 additional patients developing MI. Coronary angiography was indicated in these last 2 patients. All grafts were found to be patent. However, a native vessel required percutaneous intervention (stenting) in one of these patients. CONCLUSIONS: Early administration of a combined regimen of clopidogrel and aspirin following off-pump CABG is safe and is associated with a relatively low incidence of major adverse cardiac events, bleeding, PE, and DVT. Consequently, its routine administration after off-pump CABG is recommended.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".