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 Article therapy, 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 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 | 0.011 | 0.023 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.038 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".