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J Thorac Cardiovasc Surg 2003;126:288-289
© 2003 The American Association for Thoracic Surgery

Brief communication

Clopidogrel before urgent coronary artery bypass graft

^a Division of Cardiac Surgery, City Hospital Triemli, Zurich, Switzerland
^b Division of Anaesthesiology, City Hospital Triemli, Zurich, Switzerland
^c Division of Cardiology, City Hospital Triemli, Zurich, Switzerland

Received for publication September 27, 2002; accepted for publication October 8, 2002.

^* Division of Cardiac Surgery, City Hospital Triemli, Zurich, Switzerland
michele.genoni@triemli.stzh.ch

The first 20% of the full text of this article appears below.

The use of platelet aggregation agents, such as aspirin, glycoprotein IIb and IIIa inhibitors, and clopidogrel, has increased in recent years for patients with acute coronary syndromes, not least because of the results of the Clopidogrel in Unstable Angina to Prevent Recurrent Events study.¹ In that study, clopidogrel significantly reduced the risk of cardiovascular death, myocardial infarction, strokes, and other related ischemic events in patients with acute coronary syndromes. Clopidogrel demonstrated benefits that were incremental to and independent of other therapies that the patients might have received, such as anticoagulants, angiotensin-converting enzyme inhibitors, ß-blockers, and lipid-lowering agents. The study also confirmed the synergistic effect of the modes of action of clopidogrel and aspirin; clopidogrel inhibits adenosine 5'-diphosphate–induced platelet aggregation, whereas aspirin inhibits cyclooxygenase and reduces thromboxane A₂. The obvious inference from these findings is that all patients with an acute coronary syndrome should benefit from the favorable effects of clopidogrel, without exception and . . . [Full Text of this Article]

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