Benefit and Safety of Dual Antiplatelet Therapy after Coronary Artery Bypass Grafting for Off-pump CABG: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Aims: This study aims to evaluate benefit and safety compared dual antiplatelet therapy with single aspirin therapy after coronary artery bypass grafting.Study Design: A systematic review and Meta-analysis.Place and Duration of Study: Medline, Embase, ScienceDirect and Cochrane Library databases were searched for randomized controlled trials or observational studies focusing on anticoagulant therapy after coronary artery bypass grafting until December 2014.Methodology: Endpoints included postoperative mortality, bleeding events, myocardial infraction, stroke, repeat revascularization and graft occlusion.All these endpoints were compared between dual antiplatelet therapy and single aspirin therapy.Newcastle-Ottawa and Jadal scale were used to assess the quality of observational studies and randomized controlled trials respectively.Software R2.15.2 was utilized for Meta-analysis.Results: 15 studies composed of 31,365 patients were included.Compared with single aspirin Original Research Articletherapy, dual antiplatelet therapy resulted in reducing risk of vein graft occlusion (OR=0.53,95%CI 0.36-0.81,P=0.001), but no significant difference for artery graft occlusion (OR=0.91,95%CI 0.39-2.12,P=0.882), Risk of postoperative mortality (OR=0.57,95%CI 0.38-0.85,P=0.006) and repeat revascularization (OR=0.15,95%CI 0.05-0.45,P=0.001) was also reduced.There were no significant difference for MI (OR=0.77,95%CI 0.55-1.09,P=0.137), Stroke (OR=0.85,95%CI 0.60-1.19,P=0.330) and bleeding (OR=0.95,95%CI 0.82-1.09,P=0.465).In subgroup analysis of offpump CABG, dual antiplatelet therapy reduced risk of graft occlusion (OR=0.49,95%CI 0.30-0.82,P=0.006), MI (OR=0.28,95%CI 0.11-0.72,P=0.009), mortality (OR=0.39,95%CI 0.25-0.60,P<0.001), and did not increase risk of bleeding (OR=0.75,95%CI 0.55-1.02,P=0.066).Conclusions: Dual antiplatelet therapy reduced risk of postoperative graft occlusion and mortality in the early and late postoperative phase after CABG.It appeared to be more beneficial for offpump CABG.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.012 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".